Provider Demographics
NPI:1558970269
Name:IYER, NISHA LAKSHMI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NISHA
Middle Name:LAKSHMI
Last Name:IYER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 EL CAMINO REAL APT 1128
Mailing Address - Street 2:
Mailing Address - City:COLMA
Mailing Address - State:CA
Mailing Address - Zip Code:94014-3178
Mailing Address - Country:US
Mailing Address - Phone:718-640-5694
Mailing Address - Fax:
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1563
Practice Address - Country:US
Practice Address - Phone:415-221-2810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA826291835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist