Provider Demographics
NPI:1629545140
Name:HAMED, SHARIQ DANIYAL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHARIQ
Middle Name:DANIYAL
Last Name:HAMED
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 6TH AVE UNIT 511
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-8622
Mailing Address - Country:US
Mailing Address - Phone:509-951-4248
Mailing Address - Fax:
Practice Address - Street 1:7100 BROADWAY
Practice Address - Street 2:
Practice Address - City:LEMON GROVE
Practice Address - State:CA
Practice Address - Zip Code:91945-1401
Practice Address - Country:US
Practice Address - Phone:619-697-3415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist