Provider Demographics
NPI:1215196993
Name:HEGAB, TAHER MOHAMED (BPHARM PHD)
Entity Type:Individual
Prefix:
First Name:TAHER
Middle Name:MOHAMED
Last Name:HEGAB
Suffix:
Gender:M
Credentials:BPHARM PHD
Other - Prefix:
Other - First Name:TAHER
Other - Middle Name:
Other - Last Name:HEGAB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH PHD
Mailing Address - Street 1:7246 N LAVAL AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0323
Mailing Address - Country:US
Mailing Address - Phone:559-940-3831
Mailing Address - Fax:
Practice Address - Street 1:2990 E NEES AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-6008
Practice Address - Country:US
Practice Address - Phone:559-297-4301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60535183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist