Provider Demographics
NPI:1740044411
Name:LAED, ZIBA (RPH)
Entity type:Individual
Prefix:
First Name:ZIBA
Middle Name:
Last Name:LAED
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22330 SHERMAN WAY STE C3
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1066
Mailing Address - Country:US
Mailing Address - Phone:818-348-6600
Mailing Address - Fax:818-348-0739
Practice Address - Street 1:22330 SHERMAN WAY STE C3
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1066
Practice Address - Country:US
Practice Address - Phone:818-348-6600
Practice Address - Fax:818-348-0739
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty