Provider Demographics
NPI:1245550896
Name:MALAK, RHONDA RAAFAT (PHARMACIST)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:RAAFAT
Last Name:MALAK
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:RANDA
Other - Middle Name:RAFT
Other - Last Name:SAAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:INTERN
Mailing Address - Street 1:990 PLEASANT GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-6126
Mailing Address - Country:US
Mailing Address - Phone:916-782-2120
Mailing Address - Fax:
Practice Address - Street 1:990 PLEASANT GROVE BLVD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-6126
Practice Address - Country:US
Practice Address - Phone:916-782-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-06
Last Update Date:2010-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63806183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist