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General NPI Number Information
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NPI Number | 1215656319
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Entity Type | Individual
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Provider Name | LADAN TALEBI PHARMD, RPH
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Gender | Female
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 1800 E RIO SALADO PKWY STE 120
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City | TEMPE
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State | AZ
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Zip | 85288-2266
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Country | US
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Telephone | 480-214-2668
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Fax |
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Provider Business Mailing Address
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Address Line | 1016 W ISLETA AVE
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City | MESA
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State | AZ
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Zip | 85210-9318
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Country | US
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Telephone | 480-678-4042
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S025923
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License Number State | AZ
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