Provider Demographics
NPI:1568670313
Name:ZAHEDPOUR, SOHEILA
Entity Type:Individual
Prefix:
First Name:SOHEILA
Middle Name:
Last Name:ZAHEDPOUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 CARICIA DR
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-7133
Mailing Address - Country:US
Mailing Address - Phone:530-753-9810
Mailing Address - Fax:530-753-4569
Practice Address - Street 1:2135 COWELL BLVD
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-6388
Practice Address - Country:US
Practice Address - Phone:530-753-9810
Practice Address - Fax:530-753-4569
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist