Provider Demographics
NPI:1235517731
Name:MOHEBI, SULMAS (PHARM D)
Entity Type:Individual
Prefix:
First Name:SULMAS
Middle Name:
Last Name:MOHEBI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5351 BAYER PL
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6008
Mailing Address - Country:US
Mailing Address - Phone:310-993-9475
Mailing Address - Fax:
Practice Address - Street 1:22333 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1050
Practice Address - Country:US
Practice Address - Phone:818-713-8014
Practice Address - Fax:818-713-9925
Is Sole Proprietor?:No
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62048183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist