Provider Demographics
NPI:1316673650
Name:NADHEM, JOANNE SALAM (RPH)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:SALAM
Last Name:NADHEM
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 1:1299 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-4902
Mailing Address - Country:US
Mailing Address - Phone:619-441-8040
Mailing Address - Fax:619-441-8078
Practice Address - Street 1:1299 BROADWAY
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-4902
Practice Address - Country:US
Practice Address - Phone:619-441-8040
Practice Address - Fax:619-441-8078
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85230183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist