Provider Demographics
NPI:1063030187
Name:YUSUF, NURAT ABIOLA
Entity Type:Individual
Prefix:
First Name:NURAT
Middle Name:ABIOLA
Last Name:YUSUF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WALGREENS PHARMACY
Mailing Address - Street 2:1760 STORY ROAD
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122
Mailing Address - Country:US
Mailing Address - Phone:408-251-5933
Mailing Address - Fax:
Practice Address - Street 1:WALGREENS PHARMACY
Practice Address - Street 2:1760 STORY ROAD
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-1921
Practice Address - Country:US
Practice Address - Phone:408-251-9853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82424183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist