Provider Demographics
NPI:1558726059
Name:NASRY, RAMEZ (RPH)
Entity Type:Individual
Prefix:DR
First Name:RAMEZ
Middle Name:
Last Name:NASRY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-6258
Mailing Address - Country:US
Mailing Address - Phone:619-387-6710
Mailing Address - Fax:
Practice Address - Street 1:845 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-6258
Practice Address - Country:US
Practice Address - Phone:619-387-6710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72940183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA72940OtherPHARMACIST LICENSE