Provider Demographics
NPI:1881483022
Name:ABOUOBIA, MOHAMED ABDELKHALEK
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:ABDELKHALEK
Last Name:ABOUOBIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 S SUNRISE WAY
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-7663
Mailing Address - Country:US
Mailing Address - Phone:760-322-2784
Mailing Address - Fax:760-322-2784
Practice Address - Street 1:425 S SUNRISE WAY
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-7663
Practice Address - Country:US
Practice Address - Phone:760-322-2784
Practice Address - Fax:760-322-2784
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist