Provider Demographics
NPI:1508142092
Name:HUDA, NASEEM (M PHARM)
Entity Type:Individual
Prefix:MRS
First Name:NASEEM
Middle Name:
Last Name:HUDA
Suffix:
Gender:F
Credentials:M PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2552
Mailing Address - Country:US
Mailing Address - Phone:510-618-1504
Mailing Address - Fax:510-618-1507
Practice Address - Street 1:1456 136TH AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2552
Practice Address - Country:US
Practice Address - Phone:510-618-1504
Practice Address - Fax:510-618-1507
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 46132183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist