Provider Demographics
NPI:1255791786
Name:MAKAR, FADY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:FADY
Middle Name:
Last Name:MAKAR
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 1:15460 AVON CIR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-7019
Mailing Address - Country:US
Mailing Address - Phone:714-653-8822
Mailing Address - Fax:
Practice Address - Street 1:15460 AVON CIR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-7019
Practice Address - Country:US
Practice Address - Phone:714-653-8822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71046183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist