Provider Demographics
NPI:1073157731
Name:NOORZAI, AICHA MOUNA (PHARMD)
Entity Type:Individual
Prefix:
First Name:AICHA
Middle Name:MOUNA
Last Name:NOORZAI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14216 ONEIDA CT
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-3566
Mailing Address - Country:US
Mailing Address - Phone:720-299-4443
Mailing Address - Fax:
Practice Address - Street 1:245 S MILLS RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3435
Practice Address - Country:US
Practice Address - Phone:805-535-2753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60404183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1831376862OtherCVS