Provider Demographics
NPI:1467040915
Name:ALQEMARY, MOSTAFA N (PHARMACIST)
Entity type:Individual
Prefix:
First Name:MOSTAFA
Middle Name:N
Last Name:ALQEMARY
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7361 MIRAMONTE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4840
Mailing Address - Country:US
Mailing Address - Phone:714-588-6138
Mailing Address - Fax:
Practice Address - Street 1:1325 N ANAHEIM BLVD STE 445
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1202
Practice Address - Country:US
Practice Address - Phone:323-659-0540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82382183500000X, 1835P1200X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy