Provider Demographics
NPI:1811431521
Name:TAWFIK, EHAB-TAWFIK MONIR (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:EHAB-TAWFIK
Middle Name:MONIR
Last Name:TAWFIK
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 1:1520 N MOUNTAIN AVE # B106
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762
Mailing Address - Country:US
Mailing Address - Phone:909-391-3542
Mailing Address - Fax:909-391-6916
Practice Address - Street 1:1520 N MOUNTAIN AVE # B106
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-1128
Practice Address - Country:US
Practice Address - Phone:909-391-3542
Practice Address - Fax:909-391-6916
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55064183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist