Provider Demographics
NPI:1821673377
Name:IBRAHUIM, MONICA SHERIF
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:SHERIF
Last Name:IBRAHUIM
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 1:10109 SAINT ALBANS AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9034
Mailing Address - Country:US
Mailing Address - Phone:805-204-1658
Mailing Address - Fax:
Practice Address - Street 1:210 N CHESTER AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-4841
Practice Address - Country:US
Practice Address - Phone:800-300-6664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84157183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist