Provider Demographics
NPI:1154853471
Name:HADDADIN, RAMI
Entity Type:Individual
Prefix:
First Name:RAMI
Middle Name:
Last Name:HADDADIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 W SONYA LN
Mailing Address - Street 2:UNIT 205
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-6612
Mailing Address - Country:US
Mailing Address - Phone:312-714-5324
Mailing Address - Fax:
Practice Address - Street 1:1271 W SONYA LN
Practice Address - Street 2:UNIT 205
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-6612
Practice Address - Country:US
Practice Address - Phone:312-714-5324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68458183500000X
TX59764183500000X
WI16146-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist