Provider Demographics
NPI:1477025484
Name:ALLY, SAYED N (RPH)
Entity Type:Individual
Prefix:MR
First Name:SAYED
Middle Name:N
Last Name:ALLY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11160 ROBIN PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-7598
Mailing Address - Country:US
Mailing Address - Phone:714-213-5930
Mailing Address - Fax:760-922-6706
Practice Address - Street 1:616 E HOBSONWAY
Practice Address - Street 2:
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225-1739
Practice Address - Country:US
Practice Address - Phone:760-922-9867
Practice Address - Fax:760-922-6706
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist