Healthcare Provider Details

I. General information

NPI: 1013858893
Provider Name (Legal Business Name): MR. SAEED GOLISADE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18450 INGOMAR ST APT 324
RESEDA CA
91335-2098
US

IV. Provider business mailing address

18450 INGOMAR ST APT 324
RESEDA CA
91335-2098
US

V. Phone/Fax

Practice location:
  • Phone: 818-961-7780
  • Fax:
Mailing address:
  • Phone: 818-961-7780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number68934
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: