Healthcare Provider Details

I. General information

NPI: 1427655893
Provider Name (Legal Business Name): LORA SAMIR GHALY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E KATELLA AVE STE A
ORANGE CA
92867-4805
US

IV. Provider business mailing address

200 E KATELLA AVE STE A
ORANGE CA
92867-4805
US

V. Phone/Fax

Practice location:
  • Phone: 714-941-6177
  • Fax:
Mailing address:
  • Phone: 310-963-1921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number74977
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: