Provider Demographics
NPI:1922086156
Name:GOMAROONI, ANDREAS (PHD, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREAS
Middle Name:
Last Name:GOMAROONI
Suffix:
Gender:M
Credentials:PHD, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11273 LAUREL CANYON BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-4359
Mailing Address - Country:US
Mailing Address - Phone:213-293-0082
Mailing Address - Fax:
Practice Address - Street 1:70077 RAMON RD
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-5201
Practice Address - Country:US
Practice Address - Phone:760-895-6599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2018-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15995183500000X
MO20004014854183500000X
TX540701835P1200X
ND56311835P1200X
KS1-154981835P1200X
CA571641835P2201X, 1835P1200X
FL536391835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care