Provider Demographics
NPI:1992011605
Name:ZOHREHVAND, MONA (PHARM D)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:ZOHREHVAND
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 1:5029 DUNSMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-1108
Mailing Address - Country:US
Mailing Address - Phone:310-403-6944
Mailing Address - Fax:
Practice Address - Street 1:1808 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5610
Practice Address - Country:US
Practice Address - Phone:310-829-3951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist