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General NPI Number Information
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NPI Number | 1538709969
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Entity Type | Individual
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Provider Name | ISSAM M HABBO II PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/14/2020
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 19001 N 27TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85027-5036
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Country | US
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Telephone | 623-293-4402
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Fax |
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Provider Business Mailing Address
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Address Line | 3150 E BEARDSLEY RD UNIT 1081
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City | PHOENIX
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State | AZ
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Zip | 85050-3565
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Country | US
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Telephone | 480-272-1605
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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 | S024378
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License Number State | AZ
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