Provider Demographics
NPI:1114983954
Name:AZIZ, FASIHA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:FASIHA
Middle Name:
Last Name:AZIZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21457 E FORT BOWIE DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-5106
Mailing Address - Country:US
Mailing Address - Phone:909-598-5834
Mailing Address - Fax:
Practice Address - Street 1:12291 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2551
Practice Address - Country:US
Practice Address - Phone:562-698-2541
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist