Provider Demographics
NPI:1619516572
Name:ABULKALAM, SARAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:ABULKALAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12068 SYLVAN RIV UNIT 66
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1344
Mailing Address - Country:US
Mailing Address - Phone:714-614-7284
Mailing Address - Fax:
Practice Address - Street 1:5117 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-2413
Practice Address - Country:US
Practice Address - Phone:562-634-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-24
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist