Provider Demographics
NPI:1457834707
Name:HAMMOUDEH, FARAH SAMI ABDULHADI
Entity Type:Individual
Prefix:
First Name:FARAH
Middle Name:SAMI ABDULHADI
Last Name:HAMMOUDEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 AVENIDA DE LAS ROSAS
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95054-1419
Mailing Address - Country:US
Mailing Address - Phone:858-214-8026
Mailing Address - Fax:
Practice Address - Street 1:1920 AVENIDA DE LAS ROSAS
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054-1419
Practice Address - Country:US
Practice Address - Phone:858-214-8026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist