Provider Demographics
NPI:1629242813
Name:LOGHMAN, MARJAN (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARJAN
Middle Name:
Last Name:LOGHMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7884 GIRARD AVE
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4230
Mailing Address - Country:US
Mailing Address - Phone:858-335-3110
Mailing Address - Fax:858-729-0303
Practice Address - Street 1:550 WASHINGTON ST STE 100C
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2213
Practice Address - Country:US
Practice Address - Phone:858-335-3110
Practice Address - Fax:858-729-0303
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49374183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist