Provider Demographics
NPI:1831827344
Name:HAKIMEH, MIREILLE (RPH)
Entity type:Individual
Prefix:
First Name:MIREILLE
Middle Name:
Last Name:HAKIMEH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1638 ERIN AVE APT 21
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-1804
Mailing Address - Country:US
Mailing Address - Phone:626-260-1958
Mailing Address - Fax:
Practice Address - Street 1:1638 ERIN AVE APT 21
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91784-1804
Practice Address - Country:US
Practice Address - Phone:626-260-1958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist