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General NPI Number Information
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NPI Number | 1306295944
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Entity Type | Individual
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Provider Name | SAMY HABIB
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Gender | Male
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Dates
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Enumeration Date | 06/04/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 7119 RITA AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-4781
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Country | US
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Telephone | 323-581-9106
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Fax |
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Provider Business Mailing Address
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Address Line | 9901 PARAMOUNT BLVD STE 110
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City | DOWNEY
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State | CA
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Zip | 90240-3852
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Country | US
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Telephone | 562-806-8397
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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 | 72751
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 72751
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License Number State | CA
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