Provider Demographics
NPI:1912511189
Name:DAWOOD, SARRA KAMAL
Entity Type:Individual
Prefix:
First Name:SARRA
Middle Name:KAMAL
Last Name:DAWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 SYCAMORE TER UNIT 202
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-5595
Mailing Address - Country:US
Mailing Address - Phone:551-221-9152
Mailing Address - Fax:
Practice Address - Street 1:3939 STATE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3113
Practice Address - Country:US
Practice Address - Phone:805-681-9282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82397183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist