Healthcare Provider Details

I. General information

NPI: 1992385264
Provider Name (Legal Business Name): NIREE KALFAYAN PHARMD, BCPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 04/12/2021
Certification Date: 03/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9090 WILSHIRE BLVD STE 250
BEVERLY HILLS CA
90211-1848
US

IV. Provider business mailing address

22149 NEEDLES ST
CHATSWORTH CA
91311-4035
US

V. Phone/Fax

Practice location:
  • Phone: 310-967-7602
  • Fax:
Mailing address:
  • Phone: 818-602-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number80670
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: