Provider Demographics
NPI:1851715809
Name:ARJANG, PEJMAN
Entity Type:Individual
Prefix:
First Name:PEJMAN
Middle Name:
Last Name:ARJANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10945 BLUFFSIDE DR APT 414
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-4491
Mailing Address - Country:US
Mailing Address - Phone:310-666-6608
Mailing Address - Fax:
Practice Address - Street 1:8770 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2211
Practice Address - Country:US
Practice Address - Phone:310-275-2117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist