Provider Demographics
NPI:1528355963
Name:ISLAM, SAIF UL (RPH)
Entity type:Individual
Prefix:MR
First Name:SAIF
Middle Name:UL
Last Name:ISLAM
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 1:5017 WINAMAC DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-1807
Mailing Address - Country:US
Mailing Address - Phone:360-348-8475
Mailing Address - Fax:
Practice Address - Street 1:655 RUSSELL BLVD
Practice Address - Street 2:RITAID PHARMACY
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616
Practice Address - Country:US
Practice Address - Phone:530-756-3393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45805183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist