Provider Demographics
NPI:1437429719
Name:TABIBZADEH, NOUSHEEN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:NOUSHEEN
Middle Name:
Last Name:TABIBZADEH
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 1:12 ANDIAMO
Mailing Address - Street 2:
Mailing Address - City:NEWPORT COAST
Mailing Address - State:CA
Mailing Address - Zip Code:92657-1200
Mailing Address - Country:US
Mailing Address - Phone:949-376-9993
Mailing Address - Fax:
Practice Address - Street 1:12 ANDIAMO
Practice Address - Street 2:
Practice Address - City:NEWPORT COAST
Practice Address - State:CA
Practice Address - Zip Code:92657-1200
Practice Address - Country:US
Practice Address - Phone:949-376-9993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist