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General NPI Number Information
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NPI Number | 1952997413
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Entity Type | Individual
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Provider Name | FADI NIMAT HASSO PHARMD, RPH.
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Gender | Male
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Dates
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Enumeration Date | 12/17/2020
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Last Update Date | 12/17/2020
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Provider Practice Location Address
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Address Line | 1299 BROADWAY
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City | EL CAJON
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State | CA
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Zip | 92021-4902
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Country | US
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Telephone | 619-441-8040
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Fax |
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Provider Business Mailing Address
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Address Line | 3311 QUARTZ CIR
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City | CORONA
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State | CA
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Zip | 92882-5002
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Country | US
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Telephone | 951-264-2527
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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 | 83946
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License Number State | CA
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