MEDICARE: ELAF AL WAZEER

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	74336	CA

General Provider Information

NPI Number	:	1255031654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAF AL WAZEER

Provider Business Mailing Address
First Line	:	2121 DONAHUE DR
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92019-4221
Country	:	US
Telephone Number	:	619-212-5054
Fax Number	:

Provider Business Practice Location Address
First Line	:	455 N MAGNOLIA AVE
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-3606
Country	:	US
Telephone Number	:	619-442-0303
Fax Number	:

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

Provider Enumeration Date	:	03/06/2023
Last Update Date	:	11/20/2023

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Directions to “ ELAF AL WAZEER ” Practice Location

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