Provider Demographics
NPI:1356989263
Name:NAGIN, BASIRH NAZ (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BASIRH
Middle Name:NAZ
Last Name:NAGIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 MIDDLEBURY WAY
Mailing Address - Street 2:
Mailing Address - City:MATHER
Mailing Address - State:CA
Mailing Address - Zip Code:95655-3034
Mailing Address - Country:US
Mailing Address - Phone:916-504-8604
Mailing Address - Fax:
Practice Address - Street 1:4300 MIDDLEBURY WAY
Practice Address - Street 2:
Practice Address - City:MATHER
Practice Address - State:CA
Practice Address - Zip Code:95655-3034
Practice Address - Country:US
Practice Address - Phone:916-504-8604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80965183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist