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General NPI Number Information
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NPI Number | 1477333094
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Entity Type | Individual
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Provider Name | MARCO SAMEH ABDELMESSIH
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Gender | Male
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 600 N PACIFIC COAST HWY
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City | LAGUNA BEACH
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State | CA
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Zip | 92801
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Country | US
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Telephone | 714-905-2631
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Fax |
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Provider Business Mailing Address
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Address Line | 948 N MOHAWK AVE
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City | ANAHEIM
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State | CA
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Zip | 92801-3508
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Country | US
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Telephone | 714-905-2631
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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 | 88493
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License Number State | CA
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