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NPI Code Detail

MEDICARE: DR. MARYAM JALILI PHARMD

MEDICARE: DR. MARYAM JALILI PHARMD
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
1183500000XPharmacist87359CA
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist87359CA

General Provider Information

NPI Number : 1194435479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARYAM JALILI PHARMD
Provider Business Mailing Address
First Line : 14957 ARCHWOOD ST
Second Line :
City : VAN NUYS
State : CA
Zip : 91405-4502
Country : US
Telephone Number : 818-825-2783
Fax Number :
Provider Business Practice Location Address
First Line : 1745 GARFIELD AVE
Second Line :
City : SOUTH PASADENA
State : CA
Zip : 91030-4923
Country : US
Telephone Number : 626-799-2926
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2022
Last Update Date : 12/02/2022

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