MEDICARE: DR. SHAHRZAD JALALI-YAZDI 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	69837	CA

General Provider Information

NPI Number	:	1821406596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAHRZAD JALALI-YAZDI PHARM.D

Provider Business Mailing Address
First Line	:	4101 CRENSHAW BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-2501
Country	:	US
Telephone Number	:	323-299-8014
Fax Number	:

Provider Business Practice Location Address
First Line	:	4101 CRENSHAW BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-2501
Country	:	US
Telephone Number	:	323-299-8014
Fax Number	:

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

Provider Enumeration Date	:	07/25/2014
Last Update Date	:	07/25/2014

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