Provider Demographics
NPI:1750978250
Name:TEHRANI-WILLIAMS, DONNA V
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:V
Last Name:TEHRANI-WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:V
Other - Last Name:TEHRANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1033 N HOLLYWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2540
Mailing Address - Country:US
Mailing Address - Phone:818-955-5816
Mailing Address - Fax:
Practice Address - Street 1:1033 N HOLLYWOOD WAY
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2540
Practice Address - Country:US
Practice Address - Phone:818-955-5816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83288183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist