Provider Demographics
NPI:1619561362
Name:SHAFIZADEH, NEMAT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NEMAT
Middle Name:
Last Name:SHAFIZADEH
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 1:139 N GLENROY AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-2415
Mailing Address - Country:US
Mailing Address - Phone:310-948-9038
Mailing Address - Fax:
Practice Address - Street 1:139 N GLENROY AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-2415
Practice Address - Country:US
Practice Address - Phone:310-948-9038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy