Provider Demographics
NPI:1225662364
Name:JOLAGH, HALA SABAH ELIAS
Entity Type:Individual
Prefix:
First Name:HALA
Middle Name:SABAH ELIAS
Last Name:JOLAGH
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 1:505 N MOLLISON AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-6159
Mailing Address - Country:US
Mailing Address - Phone:619-457-0545
Mailing Address - Fax:
Practice Address - Street 1:505 N MOLLISON AVE STE 102
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-6159
Practice Address - Country:US
Practice Address - Phone:619-457-0545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH80933183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist