Provider Demographics
NPI:1528368180
Name:BAYAA, JIHAD NAIM (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JIHAD
Middle Name:NAIM
Last Name:BAYAA
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25636 CROWN VALLEY PARKWAY
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694
Mailing Address - Country:US
Mailing Address - Phone:949-429-5405
Mailing Address - Fax:
Practice Address - Street 1:26406 LOMBARDY RD
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692
Practice Address - Country:US
Practice Address - Phone:949-367-0689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 35939183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist