Provider Demographics
NPI:1407437841
Name:SADEK, MENA ANTER WILLIAM (RPH)
Entity Type:Individual
Prefix:
First Name:MENA
Middle Name:ANTER WILLIAM
Last Name:SADEK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8228 CHEYENNE AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-4318
Mailing Address - Country:US
Mailing Address - Phone:213-249-6348
Mailing Address - Fax:
Practice Address - Street 1:15740 WOODRUFF AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-4018
Practice Address - Country:US
Practice Address - Phone:562-867-5441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-17
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist