Provider Demographics
NPI:1790485811
Name:ALI, MUHAMED AKRAM (RPH)
Entity Type:Individual
Prefix:
First Name:MUHAMED
Middle Name:AKRAM
Last Name:ALI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24221 GINGERWOOD PL
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4508
Mailing Address - Country:US
Mailing Address - Phone:909-767-1791
Mailing Address - Fax:
Practice Address - Street 1:8201 GREENLEAF AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2910
Practice Address - Country:US
Practice Address - Phone:562-698-4906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH87629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1438990OtherNABP