Provider Demographics
NPI:1811270648
Name:ESKALAEI, MELIKA SHABAN (RPH)
Entity type:Individual
Prefix:
First Name:MELIKA
Middle Name:SHABAN
Last Name:ESKALAEI
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 1:4328 GENTRY AVE #3
Mailing Address - Street 2:
Mailing Address - City:STUDIO
Mailing Address - State:CA
Mailing Address - Zip Code:91664
Mailing Address - Country:US
Mailing Address - Phone:818-632-0545
Mailing Address - Fax:
Practice Address - Street 1:18430 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335
Practice Address - Country:US
Practice Address - Phone:818-343-4513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist