Healthcare Provider Details

I. General information

NPI: 1285545160
Provider Name (Legal Business Name): MADONA WASSEF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 W CULVER AVE APT 16
ORANGE CA
92868-4157
US

IV. Provider business mailing address

2005 W CULVER AVE APT 16
ORANGE CA
92868-4157
US

V. Phone/Fax

Practice location:
  • Phone: 714-808-2038
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number93197
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: