Provider Demographics
NPI:1629103171
Name:KALIL, NASER A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NASER
Middle Name:A
Last Name:KALIL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:NASER
Other - Middle Name:
Other - Last Name:ABOUKHALIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:510 JUSTIN MORGAN DR
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-2250
Mailing Address - Country:US
Mailing Address - Phone:925-838-3211
Mailing Address - Fax:925-681-1827
Practice Address - Street 1:785 OAK GROVE RD STE G2
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-3605
Practice Address - Country:US
Practice Address - Phone:925-681-1823
Practice Address - Fax:925-681-1827
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPX40009183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist