MEDICARE: FARAH ALAZIZ RPH

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	80701	CA

General Provider Information

NPI Number	:	1235760331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARAH ALAZIZ RPH

Provider Business Mailing Address
First Line	:	1610 HILTON HEAD CT APT 2263
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92019-4510
Country	:	US
Telephone Number	:	619-606-4161
Fax Number	:

Provider Business Practice Location Address
First Line	:	4153 UNIVERSITY AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92105-1421
Country	:	US
Telephone Number	:	619-333-2266
Fax Number	:	619-333-2270

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

Provider Enumeration Date	:	01/28/2020
Last Update Date	:	01/28/2020

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