Healthcare Provider Details

I. General information

NPI: 1831489814
Provider Name (Legal Business Name): REEM SABE ABU LUBDEH RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2011
Last Update Date: 04/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

599 EAST VALPICO RD
TRACY CA
95376
US

IV. Provider business mailing address

1101 PORTOLA MEADOWS RD 165
LIVERMORE CA
94551-6602
US

V. Phone/Fax

Practice location:
  • Phone: 209-830-0976
  • Fax:
Mailing address:
  • Phone: 510-508-5960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number59745
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: