Healthcare Provider Details

I. General information

NPI: 1942821970
Provider Name (Legal Business Name): TUBA NEMATI KARIMI PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2020
Last Update Date: 04/30/2020
Certification Date: 04/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N PEPPER AVE
COLTON CA
92324-1819
US

IV. Provider business mailing address

4961 ARROW HWY UNIT 220
MONTCLAIR CA
91763-1318
US

V. Phone/Fax

Practice location:
  • Phone: 909-580-1025
  • Fax: 909-580-1033
Mailing address:
  • Phone:
  • Fax: 909-580-1033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number80939
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: