Provider Demographics
NPI:1144957556
Name:IMRAN, ANUM (RPH)
Entity type:Individual
Prefix:MRS
First Name:ANUM
Middle Name:
Last Name:IMRAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7076 WELLS SPRINGS ST
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:91752-1477
Mailing Address - Country:US
Mailing Address - Phone:951-903-4506
Mailing Address - Fax:
Practice Address - Street 1:30251 MURRIETA RD
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-8385
Practice Address - Country:US
Practice Address - Phone:951-244-7210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH86015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist