Provider Demographics
NPI:1427561109
Name:GADALLA, CHRISTINA G (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:G
Last Name:GADALLA
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 1:14838 GOTHAM ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-2408
Mailing Address - Country:US
Mailing Address - Phone:818-667-9606
Mailing Address - Fax:
Practice Address - Street 1:25450 THE OLD RD
Practice Address - Street 2:
Practice Address - City:STEVENSON RANCH
Practice Address - State:CA
Practice Address - Zip Code:91381-1704
Practice Address - Country:US
Practice Address - Phone:661-253-2357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77017183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist