Healthcare Provider Details

I. General information

NPI: 1851682330
Provider Name (Legal Business Name): LAMIAA M ELREFAEI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 05/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 HOMESTEAD RD
LOS ALTOS CA
94024-7339
US

IV. Provider business mailing address

3096 ARTHUR CT
SANTA CLARA CA
95051-6802
US

V. Phone/Fax

Practice location:
  • Phone: 408-774-0134
  • Fax: 408-774-9594
Mailing address:
  • Phone: 408-250-1152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60575
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: