Provider Demographics
NPI:1407454440
Name:ZAND, SHAHRZAD
Entity Type:Individual
Prefix:
First Name:SHAHRZAD
Middle Name:
Last Name:ZAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 N FIGUEROA ST APT 5084
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3119
Mailing Address - Country:US
Mailing Address - Phone:310-945-7575
Mailing Address - Fax:
Practice Address - Street 1:275 N EL CIELO RD
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6972
Practice Address - Country:US
Practice Address - Phone:310-945-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist