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General NPI Number Information
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NPI Number | 1942948815
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Entity Type | Individual
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Provider Name | NOOSHIN AMIRTABAR PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/21/2022
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Last Update Date | 05/21/2022
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Provider Practice Location Address
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Address Line | 721 E BROADWAY STE 101
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City | GLENDALE
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State | CA
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Zip | 91205-4951
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Country | US
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Telephone | 818-396-4818
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Fax | 818-396-4816
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Provider Business Mailing Address
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Address Line | 5019 SAUNDERS CIR
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City | TEMPLE CITY
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State | CA
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Zip | 91780-3310
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Country | US
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Telephone | 949-228-3619
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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 | 85459
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License Number State | CA
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