Provider Demographics
NPI:1790263028
Name:SAYEGH, RANIA
Entity Type:Individual
Prefix:
First Name:RANIA
Middle Name:
Last Name:SAYEGH
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 1:396 MERCEDES AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-2828
Mailing Address - Country:US
Mailing Address - Phone:626-222-6082
Mailing Address - Fax:
Practice Address - Street 1:900 N LAKE AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-4563
Practice Address - Country:US
Practice Address - Phone:626-794-4714
Practice Address - Fax:626-794-5071
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53316183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist