Provider Demographics
NPI:1689317943
Name:AL ANNI, LEENA SABAH ABDULAZIZ (RPH)
Entity Type:Individual
Prefix:
First Name:LEENA
Middle Name:SABAH ABDULAZIZ
Last Name:AL ANNI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10886 CALLE VERDE APT 107
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-8504
Mailing Address - Country:US
Mailing Address - Phone:619-277-7196
Mailing Address - Fax:
Practice Address - Street 1:10886 CALLE VERDE APT 107
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-8504
Practice Address - Country:US
Practice Address - Phone:619-277-7196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85936183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist