Provider Demographics
NPI:1821797804
Name:ELBEIALY, EMAN AHMED (PHARMD)
Entity Type:Individual
Prefix:
First Name:EMAN
Middle Name:AHMED
Last Name:ELBEIALY
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 1:5113 WALNUT PLACE LN
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-3000
Mailing Address - Country:US
Mailing Address - Phone:916-588-6022
Mailing Address - Fax:
Practice Address - Street 1:38 SUNRISE LN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-2265
Practice Address - Country:US
Practice Address - Phone:916-588-6022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87496183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist