Provider Demographics
NPI:1215221171
Name:DIANAT, NAHAL (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:NAHAL
Middle Name:
Last Name:DIANAT
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 1:7100 SANTA MONICA BLVD
Mailing Address - Street 2:T-1884
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-5896
Mailing Address - Country:US
Mailing Address - Phone:323-603-0005
Mailing Address - Fax:323-603-0005
Practice Address - Street 1:7100 SANTA MONICA BLVD
Practice Address - Street 2:T-1884
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-5896
Practice Address - Country:US
Practice Address - Phone:323-603-0005
Practice Address - Fax:323-603-0005
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57412183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist