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General NPI Number Information
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NPI Number | 1295160877
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Entity Type | Individual
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Provider Name | NAGHMEH NICOLE EZRA RPH
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Gender | Female
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Dates
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Enumeration Date | 09/13/2013
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Last Update Date | 09/13/2013
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Provider Practice Location Address
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Address Line | 17864 VENTURA BLVD
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City | ENCINO
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State | CA
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Zip | 91316-3615
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Country | US
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Telephone | 818-345-5456
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Fax |
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Provider Business Mailing Address
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Address Line | 5238 BECKFORD AVE
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City | TARZANA
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State | CA
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Zip | 91356-3102
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Country | US
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Telephone | 818-388-1587
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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 | 57594
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License Number State | CA
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