Provider Demographics
NPI:1275520157
Name:MOROVATI, FARIBORZ (RPH)
Entity Type:Individual
Prefix:MR
First Name:FARIBORZ
Middle Name:
Last Name:MOROVATI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11520 DONA EVITA DR
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-4255
Mailing Address - Country:US
Mailing Address - Phone:323-848-8168
Mailing Address - Fax:
Practice Address - Street 1:21773 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1835
Practice Address - Country:US
Practice Address - Phone:818-348-0524
Practice Address - Fax:818-348-2405
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 43264183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist