MEDICARE: DIAB ABDULNOUR PHARM. D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	90015	CA

General Provider Information

NPI Number	:	1184582439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIAB ABDULNOUR PHARM. D

Provider Business Mailing Address
First Line	:	13161 YOCKEY ST APT 313
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92844-2056
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11177 TAMPA AVE STE B
Second Line	:
City	:	PORTER RANCH
State	:	CA
Zip	:	91326-2254
Country	:	US
Telephone Number	:	818-350-3998
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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