Healthcare Provider Details

I. General information

NPI: 1619514577
Provider Name (Legal Business Name): SALIBA ISHAQ PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 03/01/2026
Certification Date: 03/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 RIVERSIDE PLAZA DR
RIVERSIDE CA
92506-2723
US

IV. Provider business mailing address

32316 PAMILLA ST
WINCHESTER CA
92596-8425
US

V. Phone/Fax

Practice location:
  • Phone: 951-342-7930
  • Fax:
Mailing address:
  • Phone: 773-366-6991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number81074
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: