Provider Demographics
NPI:1437412517
Name:SADRI-NAINI, MEHRDAD (RPH)
Entity Type:Individual
Prefix:
First Name:MEHRDAD
Middle Name:
Last Name:SADRI-NAINI
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 1:7440 CIRCULO SEQUOIA
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8467
Mailing Address - Country:US
Mailing Address - Phone:858-335-8347
Mailing Address - Fax:
Practice Address - Street 1:2858 LOKER AVE E
Practice Address - Street 2:SUITE A-1
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-6666
Practice Address - Country:US
Practice Address - Phone:760-824-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47978183500000X
UT153757-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist