Provider Demographics
NPI:1447984505
Name:ALSAAD, MAIADA
Entity type:Individual
Prefix:
First Name:MAIADA
Middle Name:
Last Name:ALSAAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 CHAMBERS ST APT 58
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-3281
Mailing Address - Country:US
Mailing Address - Phone:619-402-2699
Mailing Address - Fax:
Practice Address - Street 1:440 CHAMBERS ST APT 58
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3281
Practice Address - Country:US
Practice Address - Phone:619-402-2699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86079183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist