Provider Demographics
NPI:1477935203
Name:ABOUKHALIL, AKRAM (PHARMD)
Entity Type:Individual
Prefix:
First Name:AKRAM
Middle Name:
Last Name:ABOUKHALIL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 JUSTIN MORGAN DR
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-2250
Mailing Address - Country:US
Mailing Address - Phone:925-212-5997
Mailing Address - Fax:
Practice Address - Street 1:785 OAK GROVE RD STE G2
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-3605
Practice Address - Country:US
Practice Address - Phone:925-681-1823
Practice Address - Fax:925-681-1827
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72566183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Yes183500000XPharmacy Service ProvidersPharmacist