Provider Demographics
NPI:1669766911
Name:ATTAIE, KEVIN ABBAS (PHARM D)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ABBAS
Last Name:ATTAIE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2945 TOWNSGATE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-5866
Mailing Address - Country:US
Mailing Address - Phone:747-400-9432
Mailing Address - Fax:805-230-2224
Practice Address - Street 1:2945 TOWNSGATE RD STE 200
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-5866
Practice Address - Country:US
Practice Address - Phone:747-400-9432
Practice Address - Fax:805-230-2224
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65216183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist