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General NPI Number Information
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NPI Number | 1780282608
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Entity Type | Individual
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Provider Name | GHAZALEH SHARIFZADEH PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 5270 BALBOA AVE
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City | SAN DIEGO
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State | CA
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Zip | 92117-6902
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Country | US
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Telephone | 858-292-9349
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Fax |
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Provider Business Mailing Address
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Address Line | 10858 CARAVELLE PL
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City | SAN DIEGO
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State | CA
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Zip | 92124-2047
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Country | US
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Telephone | 801-696-8393
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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 | 83274
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License Number State | CA
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