Provider Demographics
NPI:1699154823
Name:ATALLAH, SARA SAMARA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:SAMARA
Last Name:ATALLAH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1327 EL PRADO AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-2716
Mailing Address - Country:US
Mailing Address - Phone:310-328-7244
Mailing Address - Fax:310-782-3519
Practice Address - Street 1:2860 ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3421
Practice Address - Country:US
Practice Address - Phone:310-371-7541
Practice Address - Fax:310-542-1488
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA71613183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA71613OtherCA BOARD OF PHARMACY LICENSE