Provider Demographics
NPI:1528577947
Name:GOLRIZ, AREZOU (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AREZOU
Middle Name:
Last Name:GOLRIZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16461 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4368
Mailing Address - Country:US
Mailing Address - Phone:818-986-2117
Mailing Address - Fax:
Practice Address - Street 1:16461 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4368
Practice Address - Country:US
Practice Address - Phone:818-986-2117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist