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NPI Code Detail

MEDICARE: DR. MOHANNAD M ABU ALRUB PHARMD

MEDICARE:  DR. MOHANNAD M ABU ALRUB  PHARMD
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
1183500000XPharmacist84307CA

General Provider Information

NPI Number : 1801470687
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOHANNAD M ABU ALRUB PHARMD
Provider Business Mailing Address
First Line : 13428 CUMBERLAND PL
Second Line :
City : FONTANA
State : CA
Zip : 92336-5451
Country : US
Telephone Number : 909-938-6595
Fax Number :
Provider Business Practice Location Address
First Line : 9482 CALIFORNIA CITY BLVD
Second Line :
City : CALIFORNIA CITY
State : CA
Zip : 93505-2803
Country : US
Telephone Number : 760-373-5268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2021
Last Update Date : 12/26/2022

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