Provider Demographics
NPI:1659772937
Name:QAZI, ANNILA
Entity Type:Individual
Prefix:
First Name:ANNILA
Middle Name:
Last Name:QAZI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNILA
Other - Middle Name:
Other - Last Name:QAZI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1930 OAK GROVE RD
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-1607
Mailing Address - Country:US
Mailing Address - Phone:925-464-6511
Mailing Address - Fax:925-237-8100
Practice Address - Street 1:1930 OAK GROVE RD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-1607
Practice Address - Country:US
Practice Address - Phone:925-464-6511
Practice Address - Fax:925-237-8100
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70109183500000X
NJ28RI03051600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist