Healthcare Provider Details

I. General information

NPI: 1518242569
Provider Name (Legal Business Name): SHEREIF SORIAL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2011
Last Update Date: 10/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 N SEPULVEDA BLVD
MANHATTAN BEACH CA
90266-2914
US

IV. Provider business mailing address

2400 N SEPULVEDA BLVD
MANHATTAN BEACH CA
90266-2914
US

V. Phone/Fax

Practice location:
  • Phone: 424-241-1950
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number56034
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: