Provider Demographics
NPI:1619514577
Name:ISHAQ, SALIBA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SALIBA
Middle Name:
Last Name:ISHAQ
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 1:27400 BIRCH CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-5755
Mailing Address - Country:US
Mailing Address - Phone:773-366-6991
Mailing Address - Fax:
Practice Address - Street 1:25850 THE OLD RD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91381-1710
Practice Address - Country:US
Practice Address - Phone:661-254-5824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist