Provider Demographics
NPI:1104195049
Name:ABDELREHIM, HANY T (RPH)
Entity Type:Individual
Prefix:
First Name:HANY
Middle Name:T
Last Name:ABDELREHIM
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 1:40301 ROSEWELL CT
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-2505
Mailing Address - Country:US
Mailing Address - Phone:619-392-0666
Mailing Address - Fax:
Practice Address - Street 1:40301 ROSEWELL CT
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-2505
Practice Address - Country:US
Practice Address - Phone:619-392-0666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH60819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist