MEDICARE: MS. NAHAL DIANAT PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	57412	CA

General Provider Information

NPI Number	:	1215221171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NAHAL DIANAT PHARM.D.

Provider Business Mailing Address
First Line	:	7100 SANTA MONICA BLVD
Second Line	:	T-1884
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-5896
Country	:	US
Telephone Number	:	323-603-0005
Fax Number	:	323-603-0005

Provider Business Practice Location Address
First Line	:	7100 SANTA MONICA BLVD
Second Line	:	T-1884
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-5896
Country	:	US
Telephone Number	:	323-603-0005
Fax Number	:	323-603-0005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2011
Last Update Date	:	06/07/2011

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