Provider Demographics
NPI:1871032888
Name:HADI, AYMAN
Entity Type:Individual
Prefix:
First Name:AYMAN
Middle Name:
Last Name:HADI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5712 BALTIMORE DR UNIT 453
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-1695
Mailing Address - Country:US
Mailing Address - Phone:619-387-6263
Mailing Address - Fax:
Practice Address - Street 1:5712 BALTIMORE DR UNIT 453
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-1695
Practice Address - Country:US
Practice Address - Phone:619-387-6263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH685321835C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0205XPharmacy Service ProvidersPharmacistCritical Care