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General NPI Number Information
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NPI Number | 1255643524
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Entity Type | Individual
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Provider Name | EMAD ELDIN MAHMOUD
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Gender | Male
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Dates
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Enumeration Date | 07/02/2010
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 1049 W GARDENA BLVD STE A
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City | GARDENA
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State | CA
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Zip | 90247-4957
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Country | US
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Telephone | 213-878-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 8834 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035-3302
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Country | US
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Telephone | 213-878-1200
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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 | RPH025839
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 054396
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302037201
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 51294043
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH 74850
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License Number State | CA
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