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General NPI Number Information
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NPI Number | 1972887404
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Entity Type | Individual
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Provider Name | NASRIN KHATIBI RPH
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Gender | Female
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Dates
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Enumeration Date | 10/03/2011
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | 41400 BLACOW RD
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City | FREMONT
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State | CA
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Zip | 94538-3387
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Country | US
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Telephone | 510-440-8195
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Fax | 510-440-0810
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Provider Business Mailing Address
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Address Line | 3599 GILMAN COMMONS
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City | FREMONT
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State | CA
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Zip | 94538
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Country | US
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Telephone | 510-656-5141
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Fax | 510-656-5141
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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 | 46174
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License Number State | CA
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