Healthcare Provider Details

I. General information

NPI: 1497371082
Provider Name (Legal Business Name): MOHAMED NAHSHAL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2020
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 UNIVERSITY AVE
SAN DIEGO CA
92103-7325
US

IV. Provider business mailing address

7260 EMANON ST
DEARBORN MI
48126-1626
US

V. Phone/Fax

Practice location:
  • Phone: 619-298-5181
  • Fax:
Mailing address:
  • Phone: 313-319-7737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH84230
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302412169
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: