Provider Demographics
NPI:1336678069
Name:ALQASEER, SAIF QURAISH FAZEA
Entity Type:Individual
Prefix:
First Name:SAIF
Middle Name:QURAISH FAZEA
Last Name:ALQASEER
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 1:6360 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3155
Mailing Address - Country:US
Mailing Address - Phone:323-937-3019
Mailing Address - Fax:
Practice Address - Street 1:6360 W 3RD ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3155
Practice Address - Country:US
Practice Address - Phone:323-937-3019
Practice Address - Fax:323-937-3019
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-06
Last Update Date:2017-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73849183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist