Healthcare Provider Details

I. General information

NPI: 1235436338
Provider Name (Legal Business Name): BILAL ZAATITI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2011
Last Update Date: 02/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5881 E CHARLESTON BLVD
LAS VEGAS NV
89142-1010
US

IV. Provider business mailing address

6486 AMERICAN BEAUTY AVE
LAS VEGAS NV
89142-7901
US

V. Phone/Fax

Practice location:
  • Phone: 702-457-1503
  • Fax:
Mailing address:
  • Phone: 702-557-2626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17263
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: