Provider Demographics
NPI:1992779888
Name:NASRY, MONEIS A (RPH)
Entity type:Individual
Prefix:DR
First Name:MONEIS
Middle Name:A
Last Name:NASRY
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 1:1497 CAMINO DE NOG
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-4633
Mailing Address - Country:US
Mailing Address - Phone:760-728-1761
Mailing Address - Fax:
Practice Address - Street 1:1200 VISTA WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054
Practice Address - Country:US
Practice Address - Phone:760-966-0143
Practice Address - Fax:760-966-0259
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41640183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist