Healthcare Provider Details

I. General information

NPI: 1871600155
Provider Name (Legal Business Name): SAMIHA O ZAGHLOUL RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11201 BENTON ST
LOMA LINDA CA
92357-1000
US

IV. Provider business mailing address

6752 CAROBWOOD WAY
RIVERSIDE CA
92506-6208
US

V. Phone/Fax

Practice location:
  • Phone: 909-825-7084
  • Fax:
Mailing address:
  • Phone: 951-789-1008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number44055
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: