Provider Demographics
NPI:1790059145
Name:AWAD, RANDA HANNA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:RANDA
Middle Name:HANNA
Last Name:AWAD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 TRES PINOS RD
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-5569
Mailing Address - Country:US
Mailing Address - Phone:831-638-3247
Mailing Address - Fax:
Practice Address - Street 1:591 TRES PINOS RD
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5569
Practice Address - Country:US
Practice Address - Phone:831-638-3247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-02
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57936183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist