Provider Demographics
NPI:1972275477
Name:PARZIDINOV, SAIDOLIM MADUMAROVICH (RPH)
Entity Type:Individual
Prefix:
First Name:SAIDOLIM
Middle Name:MADUMAROVICH
Last Name:PARZIDINOV
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2690 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-2923
Mailing Address - Country:US
Mailing Address - Phone:661-872-3821
Mailing Address - Fax:661-872-9940
Practice Address - Street 1:2690 MOUNT VERNON AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-2923
Practice Address - Country:US
Practice Address - Phone:661-872-3821
Practice Address - Fax:661-872-9940
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-02
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist