Individual provider · NPI-1

Farah Shaker Abed Abuazzam

Student in an Organized Health Care Education/Training Program · Loma Linda, CA

NPI number1013589241
StatusActive
Last updated in NPPESJul 20, 2021

Details

NPI
1013589241
Entity type
Individual (NPI-1)
Name
Farah Shaker Abed Abuazzam
Sex
Female
Sole proprietor
No
Enumeration date
Jul 16, 2021
Certification date
Jul 20, 2021
Last updated
Jul 20, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

11234 Anderson Street
Loma Linda, CA 92354-2804

Phone 909-558-4911

Mailing address

11234 Anderson Street
Gme Office Westerly Suite C
Loma Linda, CA 92354-2804

Phone 909-558-4911

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