Provider Demographics
NPI:1942583158
Name:SAEED, SAMRA (B-PHARM)
Entity Type:Individual
Prefix:
First Name:SAMRA
Middle Name:
Last Name:SAEED
Suffix:
Gender:F
Credentials:B-PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21721 GOLDEN STAR BLVD
Mailing Address - Street 2:APT C
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-9641
Mailing Address - Country:US
Mailing Address - Phone:661-750-4545
Mailing Address - Fax:
Practice Address - Street 1:1101 W TEHACHAPI BLVD
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-2559
Practice Address - Country:US
Practice Address - Phone:661-823-0163
Practice Address - Fax:661-823-0742
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist