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General NPI Number Information
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NPI Number | 1225677628
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Entity Type | Individual
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Provider Name | SAMEY ABDULRUB PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/02/2020
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | 638 CAMINO DE LOS MARES
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-2848
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Country | US
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Telephone | 949-487-9791
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Fax |
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Provider Business Mailing Address
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Address Line | 24125 HOLLYOAK APT J
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City | ALISO VIEJO
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State | CA
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Zip | 92656-7906
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Country | US
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Telephone | 313-983-9034
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 81726
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License Number State | CA
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