Provider Demographics
NPI:1003203977
Name:NAZARIAN, PARGOL KHORSANDI (PHARMD)
Entity Type:Individual
Prefix:
First Name:PARGOL
Middle Name:KHORSANDI
Last Name:NAZARIAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:PARGOL
Other - Middle Name:
Other - Last Name:KHORSANDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:110 N ANITA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-2720
Mailing Address - Country:US
Mailing Address - Phone:310-463-8586
Mailing Address - Fax:
Practice Address - Street 1:5901 E 7TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90822-5201
Practice Address - Country:US
Practice Address - Phone:562-826-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-18
Last Update Date:2015-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA644801835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist