Provider Demographics
NPI:1346788452
Name:ALSAMARAH, ABDELAZIZ (RPH)
Entity type:Individual
Prefix:
First Name:ABDELAZIZ
Middle Name:
Last Name:ALSAMARAH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-2834
Mailing Address - Country:US
Mailing Address - Phone:951-530-8800
Mailing Address - Fax:
Practice Address - Street 1:1340 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-2834
Practice Address - Country:US
Practice Address - Phone:951-530-8800
Practice Address - Fax:951-530-4801
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist