Healthcare Provider Details

I. General information

NPI: 1881158665
Provider Name (Legal Business Name): ROMANY IBRAHIM PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2019
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 S BRADLEY RD
SANTA MARIA CA
93455-1348
US

IV. Provider business mailing address

3680 WILSHIRE BLVD STE PO41010
LOS ANGELES CA
90010-2707
US

V. Phone/Fax

Practice location:
  • Phone: 805-349-7885
  • Fax:
Mailing address:
  • Phone: 949-391-8641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number77725
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: