Provider Demographics
NPI:1861008906
Name:MORADKHAN, ARBI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ARBI
Middle Name:
Last Name:MORADKHAN
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 1:2254 MIRA VISTA AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1537
Mailing Address - Country:US
Mailing Address - Phone:818-279-1865
Mailing Address - Fax:
Practice Address - Street 1:2254 MIRA VISTA AVE APT 4
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1537
Practice Address - Country:US
Practice Address - Phone:661-940-4752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83430183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist