Provider Demographics
NPI:1497238125
Name:GIRGIS, SARA SHOHDY KARAM
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:SHOHDY KARAM
Last Name:GIRGIS
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 1:4949 GOSFORD RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-4992
Mailing Address - Country:US
Mailing Address - Phone:661-858-0218
Mailing Address - Fax:
Practice Address - Street 1:4949 GOSFORD RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-4992
Practice Address - Country:US
Practice Address - Phone:661-858-0218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-09
Last Update Date:2018-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76350183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist