Provider Demographics
NPI:1679862429
Name:KOBARI, MOJGAN A (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:MOJGAN
Middle Name:A
Last Name:KOBARI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9520 ROD RD
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8539
Mailing Address - Country:US
Mailing Address - Phone:770-619-2252
Mailing Address - Fax:
Practice Address - Street 1:2323 CANTON HWY
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-4322
Practice Address - Country:US
Practice Address - Phone:770-888-5031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA18770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist