Provider Demographics
NPI:1659641843
Name:LAHIJI, ELHAM
Entity Type:Individual
Prefix:
First Name:ELHAM
Middle Name:
Last Name:LAHIJI
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 1:1836 PARNELL AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-8325
Mailing Address - Country:US
Mailing Address - Phone:310-488-9548
Mailing Address - Fax:
Practice Address - Street 1:1836 PARNELL AVE APT 205
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-8325
Practice Address - Country:US
Practice Address - Phone:310-488-9548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist