Individual
ISRAA QASIM POULLATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
42001 MARGARITA RD, APT#220, TEMECULA, CA 92591-5772
(254) 421-6533
Mailing address
42001 MARGARITA RD, APT#220, TEMECULA, CA 92591-5772
(254) 421-6533
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
97436254F84077
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
97436254F84077
MEDICAL
CA
Enumeration date
05/05/2014
Last updated
05/05/2014
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