Provider Demographics
NPI:1962161125
Name:ABDELHAK, ASHRAF
Entity type:Individual
Prefix:
First Name:ASHRAF
Middle Name:
Last Name:ABDELHAK
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 1:9800 BASELINE RD SPC 57
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-5944
Mailing Address - Country:US
Mailing Address - Phone:818-636-5341
Mailing Address - Fax:
Practice Address - Street 1:9800 BASELINE RD SPC 57
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91701-5944
Practice Address - Country:US
Practice Address - Phone:818-636-5341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date: