Provider Demographics
NPI:1891343091
Name:GIRGUIS, MARIE SAMIR (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:MARIE
Middle Name:SAMIR
Last Name:GIRGUIS
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 1:8594 ROGUE RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5516
Mailing Address - Country:US
Mailing Address - Phone:714-200-4536
Mailing Address - Fax:
Practice Address - Street 1:540 CANAL ST
Practice Address - Street 2:
Practice Address - City:KING CITY
Practice Address - State:CA
Practice Address - Zip Code:93930-3446
Practice Address - Country:US
Practice Address - Phone:831-385-0866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty