Healthcare Provider Details

I. General information

NPI: 1851327233
Provider Name (Legal Business Name): HALA D MOUWAKEH RPH,M.S
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VA SAN DIEGO HEALTHCARE SYSTEM 3350 LAJOLLA VILLAGE DRIVE
SAN DIEGO CA
92161-0001
US

IV. Provider business mailing address

9748 CAMINITO DOHA
SAN DIEGO CA
92131-1625
US

V. Phone/Fax

Practice location:
  • Phone: 858-552-8585
  • Fax:
Mailing address:
  • Phone: 858-695-9519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number0378891
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: