Provider Demographics
NPI:1013570761
Name:NAMDAR, NEDA (PHARM D)
Entity Type:Individual
Prefix:
First Name:NEDA
Middle Name:
Last Name:NAMDAR
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 GOLDEN EAGLE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-0308
Mailing Address - Country:US
Mailing Address - Phone:949-606-3737
Mailing Address - Fax:
Practice Address - Street 1:14330 CULVER DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-0303
Practice Address - Country:US
Practice Address - Phone:949-559-8129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA521261835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA52126OtherPHARMACIST LICENSE NUMBER