Provider Demographics
NPI:1164579629
Name:QABAZARD, NASER MANSOUR (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:NASER
Middle Name:MANSOUR
Last Name:QABAZARD
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 1:401 BICENTENNIAL WAY
Mailing Address - Street 2:KAISER PERMANENTE, IN-PATIENT HOSPITAL PHARMACY
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-0167
Mailing Address - Country:US
Mailing Address - Phone:707-571-4700
Mailing Address - Fax:707-571-4701
Practice Address - Street 1:401 BICENTENNIAL WAY
Practice Address - Street 2:KAISER PERMANENTE
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403
Practice Address - Country:US
Practice Address - Phone:707-571-4700
Practice Address - Fax:707-571-4701
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA591521835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy