Provider Demographics
NPI:1407314628
Name:MAKKAR, RAMZY
Entity Type:Individual
Prefix:
First Name:RAMZY
Middle Name:
Last Name:MAKKAR
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 1:16220 CORNUTA AVE APT 52
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-8639
Mailing Address - Country:US
Mailing Address - Phone:310-766-9251
Mailing Address - Fax:
Practice Address - Street 1:6840 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4256
Practice Address - Country:US
Practice Address - Phone:951-369-9941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty