Provider Demographics
NPI:1689916777
Name:MAQBOOL, BASIL JAWAID (PHARM-D)
Entity Type:Individual
Prefix:MR
First Name:BASIL
Middle Name:JAWAID
Last Name:MAQBOOL
Suffix:
Gender:M
Credentials:PHARM-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32605 TEMECULA PKWY
Mailing Address - Street 2:SUITE 304
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-6837
Mailing Address - Country:US
Mailing Address - Phone:951-302-4903
Mailing Address - Fax:951-302-4904
Practice Address - Street 1:32675 TEMECULA PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-6917
Practice Address - Country:US
Practice Address - Phone:951-303-8300
Practice Address - Fax:951-303-8322
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53170183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist