Provider Demographics
NPI:1710414412
Name:ALSAIEGH, NATALINE
Entity Type:Individual
Prefix:
First Name:NATALINE
Middle Name:
Last Name:ALSAIEGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9089 WOODMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-6404
Mailing Address - Country:US
Mailing Address - Phone:818-892-3167
Mailing Address - Fax:818-891-5924
Practice Address - Street 1:9089 WOODMAN AVE
Practice Address - Street 2:
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331
Practice Address - Country:US
Practice Address - Phone:818-892-3167
Practice Address - Fax:818-891-5924
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66737183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist