Provider Demographics
NPI:1073921425
Name:NASERI, RAHA KATHERINE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:RAHA
Middle Name:KATHERINE
Last Name:NASERI
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 1:2770 CARSON ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-4011
Mailing Address - Country:US
Mailing Address - Phone:714-227-8004
Mailing Address - Fax:
Practice Address - Street 1:2770 CARSON ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-4011
Practice Address - Country:US
Practice Address - Phone:562-429-9960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH70100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist