Provider Demographics
NPI:1992978431
Name:NOWBAR, SEYED ALI (RPH)
Entity type:Individual
Prefix:MR
First Name:SEYED
Middle Name:ALI
Last Name:NOWBAR
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 1:581 MCCRAY ST
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-4091
Mailing Address - Country:US
Mailing Address - Phone:831-630-3100
Mailing Address - Fax:831-630-1120
Practice Address - Street 1:581 MCCRAY ST
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-4091
Practice Address - Country:US
Practice Address - Phone:831-630-3100
Practice Address - Fax:831-630-1120
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist