Provider Demographics
NPI:1841511755
Name:ALKHAIRULLA, NADA YOUNIS (RPH)
Entity type:Individual
Prefix:
First Name:NADA
Middle Name:YOUNIS
Last Name:ALKHAIRULLA
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 1:4278 BIDWELL DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2644
Mailing Address - Country:US
Mailing Address - Phone:510-979-0760
Mailing Address - Fax:510-979-0770
Practice Address - Street 1:1650 DECOTO RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-3544
Practice Address - Country:US
Practice Address - Phone:510-429-0195
Practice Address - Fax:510-429-0403
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51660183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist