Provider Demographics
NPI:1538775903
Name:EL-ALI, JASIM MOHAMMAD (PHARMD, MLS)
Entity type:Individual
Prefix:DR
First Name:JASIM
Middle Name:MOHAMMAD
Last Name:EL-ALI
Suffix:
Gender:M
Credentials:PHARMD, MLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10555 N ORACLE RD
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-9353
Mailing Address - Country:US
Mailing Address - Phone:520-219-4151
Mailing Address - Fax:
Practice Address - Street 1:10555 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85737-9353
Practice Address - Country:US
Practice Address - Phone:520-219-4151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS025630183500000X
AZ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No183500000XPharmacy Service ProvidersPharmacist