Healthcare Provider Details

I. General information

NPI: 1356669808
Provider Name (Legal Business Name): GHASSAN E NESHEIWAT PHARMACIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2010
Last Update Date: 05/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8508 PAINTER AVE
WHITTIER CA
90602-3335
US

IV. Provider business mailing address

8508 PAINTER AVE
WHITTIER CA
90602-3335
US

V. Phone/Fax

Practice location:
  • Phone: 562-945-7940
  • Fax: 562-945-7940
Mailing address:
  • Phone: 714-521-6647
  • Fax: 714-521-6647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH47650
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: