Provider Demographics
NPI:1801450507
Name:NAFISI, NIAZ (PHARM D)
Entity type:Individual
Prefix:
First Name:NIAZ
Middle Name:
Last Name:NAFISI
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 1:1059 HYDE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4916
Mailing Address - Country:US
Mailing Address - Phone:415-346-6100
Mailing Address - Fax:415-346-6109
Practice Address - Street 1:1059 HYDE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4916
Practice Address - Country:US
Practice Address - Phone:415-346-6100
Practice Address - Fax:415-346-6109
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-28
Last Update Date:2019-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79661183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist