Provider Demographics
NPI:1053770677
Name:ALI, NASEEM (REGISTERED PHARMACIS)
Entity type:Individual
Prefix:
First Name:NASEEM
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:REGISTERED PHARMACIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3836 KEYSTONE AVE # APPTNO1
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3332
Mailing Address - Country:US
Mailing Address - Phone:310-904-8283
Mailing Address - Fax:
Practice Address - Street 1:3836 KEYSTONE AVE APT 1
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-3332
Practice Address - Country:US
Practice Address - Phone:310-904-8283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist