Healthcare Provider Details

I. General information

NPI: 1063360105
Provider Name (Legal Business Name): PHARM-ONE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E SAN YSIDRO BLVD STE 160
SAN YSIDRO CA
92173-3138
US

IV. Provider business mailing address

601 E SAN YSIDRO BLVD STE 160
SAN YSIDRO CA
92173-3138
US

V. Phone/Fax

Practice location:
  • Phone: 619-374-0005
  • Fax: 619-374-0006
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: OMAR ALQAM
Title or Position: CEO
Credential:
Phone: 619-374-0005