Healthcare Provider Details

I. General information

NPI: 1083348593
Provider Name (Legal Business Name): RAFIK NAZARPOOR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2022
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11000 VENTURA BLVD
STUDIO CITY CA
91604-3546
US

IV. Provider business mailing address

7723 JAYSEEL ST
TUJUNGA CA
91042-1621
US

V. Phone/Fax

Practice location:
  • Phone: 818-761-6563
  • Fax:
Mailing address:
  • Phone: 818-288-5949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number86208
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: