Provider Demographics
NPI:1003285875
Name:ATALLAH, AHMED SADEK (PHD, RPH)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:SADEK
Last Name:ATALLAH
Suffix:
Gender:M
Credentials:PHD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 EL PRADO AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-2716
Mailing Address - Country:US
Mailing Address - Phone:310-328-7244
Mailing Address - Fax:310-782-3519
Practice Address - Street 1:1327 EL PRADO AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-2716
Practice Address - Country:US
Practice Address - Phone:310-328-7244
Practice Address - Fax:310-782-3519
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist