Healthcare Provider Details

I. General information

NPI: 1821702770
Provider Name (Legal Business Name): MELIKA NASR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 SANTA BARBARA CT
FOOTHILL RANCH CA
92610-2400
US

IV. Provider business mailing address

10 SANTA BARBARA CT
FOOTHILL RANCH CA
92610-2400
US

V. Phone/Fax

Practice location:
  • Phone: 949-246-4199
  • Fax:
Mailing address:
  • Phone: 949-246-4199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number87007
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: