Healthcare Provider Details

I. General information

NPI: 1255484457
Provider Name (Legal Business Name): PARMIS KHATIBI PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S UCI MEDICAL CENTER ROUTE 32 BUILDING 25
ORANGE CA
92868-3201
US

IV. Provider business mailing address

101 THE CITY DR S UCI MEDICAL CENTER ROUTE 32 BUILDING 25
ORANGE CA
92868-3201
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-5621
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number56348
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: