Provider Demographics
NPI:1083348593
Name:NAZARPOOR, RAFIK (PHARMD)
Entity Type:Individual
Prefix:
First Name:RAFIK
Middle Name:
Last Name:NAZARPOOR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7723 JAYSEEL ST
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-1621
Mailing Address - Country:US
Mailing Address - Phone:818-288-5949
Mailing Address - Fax:
Practice Address - Street 1:11000 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-3546
Practice Address - Country:US
Practice Address - Phone:818-761-6563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86208183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty