Provider Demographics
NPI:1477088961
Name:PARHIZKAR, MORTEZA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MORTEZA
Middle Name:
Last Name:PARHIZKAR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2428 WINDWARD DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-3698
Mailing Address - Country:US
Mailing Address - Phone:505-506-8660
Mailing Address - Fax:
Practice Address - Street 1:301 SAN MATEO BLVD SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-5629
Practice Address - Country:US
Practice Address - Phone:505-262-1915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-22
Last Update Date:2017-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008596183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist