Healthcare Provider Details

I. General information

NPI: 1689186462
Provider Name (Legal Business Name): SONIA DAOUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2017
Last Update Date: 11/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 N HARBOR BLVD
SANTA ANA CA
92703-3337
US

IV. Provider business mailing address

9322 SISKIN AVE
FOUNTAIN VALLEY CA
92708-6554
US

V. Phone/Fax

Practice location:
  • Phone: 714-554-7120
  • Fax:
Mailing address:
  • Phone: 714-330-9702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number59299
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: