MEDICARE: TALA GOLZAR

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	87798	CA

General Provider Information

NPI Number	:	1205538857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TALA GOLZAR

Provider Business Mailing Address
First Line	:	5525 CANOGA AVE APT 230
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-6648
Country	:	US
Telephone Number	:	310-499-3230
Fax Number	:

Provider Business Practice Location Address
First Line	:	5525 CANOGA AVE APT 230
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-6648
Country	:	US
Telephone Number	:	310-499-3230
Fax Number	:

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

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	03/20/2023

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Directions to “ TALA GOLZAR ” Practice Location

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