Provider Demographics
NPI:1235599457
Name:INAM, REEM (PHARMD)
Entity Type:Individual
Prefix:
First Name:REEM
Middle Name:
Last Name:INAM
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 1:95 HOLGER WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-1377
Mailing Address - Country:US
Mailing Address - Phone:408-834-1528
Mailing Address - Fax:
Practice Address - Street 1:2219 FARRELL AVE APT 4
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-1862
Practice Address - Country:US
Practice Address - Phone:310-292-3623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPHRM.PH.61042166183500000X
CA74041183500000X
ORRPH-0015067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist