Provider Demographics
NPI:1467234799
Name:CROUCH, NADIA MASROOR (PHARMD, MPH)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:MASROOR
Last Name:CROUCH
Suffix:
Gender:F
Credentials:PHARMD, MPH
Other - Prefix:
Other - First Name:NADIA
Other - Middle Name:
Other - Last Name:MASROOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 773
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90294-0773
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 W HELLMAN AVE STE 303
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1209
Practice Address - Country:US
Practice Address - Phone:310-256-2537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31428183500000X
CA87831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist