Healthcare Provider Details

I. General information

NPI: 1124982962
Provider Name (Legal Business Name): HELEN HANNA SHABA AL HNOQ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5644 MISSION CENTER RD # 201
SAN DIEGO CA
92108-4328
US

IV. Provider business mailing address

1234 E WASHINGTON AVE
EL CAJON CA
92019-3036
US

V. Phone/Fax

Practice location:
  • Phone: 619-298-3655
  • Fax:
Mailing address:
  • Phone: 619-908-0917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH90969
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: