Provider Demographics
NPI:1376980987
Name:ZEIN AMODEO, AMAL H (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AMAL
Middle Name:H
Last Name:ZEIN AMODEO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:AMAL
Other - Middle Name:H
Other - Last Name:ZEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:325 ROLLING OAKS DR STE 140
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1077
Mailing Address - Country:US
Mailing Address - Phone:805-557-1006
Mailing Address - Fax:805-557-1706
Practice Address - Street 1:325 ROLLING OAKS DR STE 140
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1077
Practice Address - Country:US
Practice Address - Phone:805-557-1006
Practice Address - Fax:805-557-1706
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH39798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist