Provider Demographics
NPI:1861815417
Name:ELHAJ, BERNARD R (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:R
Last Name:ELHAJ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 N LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1836
Mailing Address - Country:US
Mailing Address - Phone:626-793-0531
Mailing Address - Fax:626-793-1525
Practice Address - Street 1:160 N LAKE AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1836
Practice Address - Country:US
Practice Address - Phone:626-793-0531
Practice Address - Fax:626-793-1525
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist