Provider Demographics
NPI:1427627942
Name:ALMUKDAD, SAM K (PHARMD)
Entity type:Individual
Prefix:
First Name:SAM
Middle Name:K
Last Name:ALMUKDAD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 SAINT MICHAELS CT
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2161
Mailing Address - Country:US
Mailing Address - Phone:415-518-6871
Mailing Address - Fax:
Practice Address - Street 1:32980 ALVARADO NILES RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-8104
Practice Address - Country:US
Practice Address - Phone:800-552-5520
Practice Address - Fax:800-893-6623
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-19
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist