Provider Demographics
NPI:1023307618
Name:GHOBRIAL, EMAD N (RPH)
Entity type:Individual
Prefix:
First Name:EMAD
Middle Name:N
Last Name:GHOBRIAL
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 1:409 PEPPER DR APT F
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-7064
Mailing Address - Country:US
Mailing Address - Phone:559-415-9818
Mailing Address - Fax:
Practice Address - Street 1:409 PEPPER DR APT F
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-7064
Practice Address - Country:US
Practice Address - Phone:559-415-9818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist