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NPI Code Detail

MEDICARE: SHAHAD ISAM A ATTAR

MEDICARE: SHAHAD ISAM A ATTAR
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
1183500000XPharmacist85702CA

General Provider Information

NPI Number : 1417600594
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAHAD ISAM A ATTAR
Provider Business Mailing Address
First Line : 4029 43RD ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92105-1510
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 599 CHAMBERS ST APT C
Second Line :
City : EL CAJON
State : CA
Zip : 92020-3243
Country : US
Telephone Number : 619-569-0543
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2022
Last Update Date : 01/30/2022

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Directions to “ SHAHAD ISAM A ATTAR ” Practice Location

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