Provider Demographics
NPI:1174897300
Name:KHOURY, SYLVIA M (PHARMD)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:M
Last Name:KHOURY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1099 E HOSPITALITY LN
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-2813
Mailing Address - Country:US
Mailing Address - Phone:909-478-5662
Mailing Address - Fax:909-478-0294
Practice Address - Street 1:1099 E HOSPITALITY LN
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-2813
Practice Address - Country:US
Practice Address - Phone:909-478-5662
Practice Address - Fax:909-478-0294
Is Sole Proprietor?:No
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist