Provider Demographics
NPI:1407496151
Name:OURMAZDI, PARISA (PHARMD)
Entity Type:Individual
Prefix:
First Name:PARISA
Middle Name:
Last Name:OURMAZDI
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 1:12445 POMERADO PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2131
Mailing Address - Country:US
Mailing Address - Phone:858-449-4026
Mailing Address - Fax:
Practice Address - Street 1:3752 MISSION AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1417
Practice Address - Country:US
Practice Address - Phone:760-722-9409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist