Provider Demographics
NPI:1043554587
Name:MASIH, AMGAD MOHSEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:AMGAD
Middle Name:MOHSEN
Last Name:MASIH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 SEQUOIA AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3176
Mailing Address - Country:US
Mailing Address - Phone:805-416-8900
Mailing Address - Fax:805-823-7767
Practice Address - Street 1:1960 SEQUOIA AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3176
Practice Address - Country:US
Practice Address - Phone:805-416-8900
Practice Address - Fax:805-823-7767
Is Sole Proprietor?:No
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57887183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist