Provider Demographics
NPI:1386142669
Name:MERRAWI, GHASSAN (RPH)
Entity type:Individual
Prefix:
First Name:GHASSAN
Middle Name:
Last Name:MERRAWI
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 1:15010 W WHITESBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:KERMAN
Mailing Address - State:CA
Mailing Address - Zip Code:93630-1030
Mailing Address - Country:US
Mailing Address - Phone:559-400-8883
Mailing Address - Fax:855-571-3458
Practice Address - Street 1:15010 W WHITESBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:KERMAN
Practice Address - State:CA
Practice Address - Zip Code:93630-1030
Practice Address - Country:US
Practice Address - Phone:559-400-8883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-31
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist