MEDICARE: MARGARET NASRIN BAHRAMI R.PH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	52424	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	52424	OTHER	CA	CA STATE BOARD OF PHARMACY

General Provider Information

NPI Number	:	1104224427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET NASRIN BAHRAMI R.PH

Provider Business Mailing Address
First Line	:	2173 CAMINO DEL ESTE APT 6417
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1557
Country	:	US
Telephone Number	:	619-301-9984
Fax Number	:

Provider Business Practice Location Address
First Line	:	2173 CAMINO DEL ESTE APT 6417
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1557
Country	:	US
Telephone Number	:	619-301-9984
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2014
Last Update Date	:	12/18/2014

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