Healthcare Provider Details

I. General information

NPI: 1518346477
Provider Name (Legal Business Name): AZITA ZAER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2015
Last Update Date: 05/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8510 BALBOA BLVD STE 175
NORTHRIDGE CA
91325-5803
US

IV. Provider business mailing address

8510 BALBOA BLVD STE 175
NORTHRIDGE CA
91325-5803
US

V. Phone/Fax

Practice location:
  • Phone: 818-637-2000
  • Fax:
Mailing address:
  • Phone: 818-637-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number68569
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: