Provider Demographics
NPI:1851764088
Name:ALLAHWERDY, YOUSIF
Entity type:Individual
Prefix:
First Name:YOUSIF
Middle Name:
Last Name:ALLAHWERDY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11523 FURY LN UNIT 110
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-4343
Mailing Address - Country:US
Mailing Address - Phone:619-219-1276
Mailing Address - Fax:
Practice Address - Street 1:11523 FURY LN UNIT 110
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-4343
Practice Address - Country:US
Practice Address - Phone:619-219-1276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist