Provider Demographics
NPI:1831683614
Name:NEKONEJAD, NAZANIN NANCY (PHARM D)
Entity type:Individual
Prefix:MS
First Name:NAZANIN
Middle Name:NANCY
Last Name:NEKONEJAD
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 1:3828 SCHAUFELE AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1793
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3828 SCHAUFELE AVE STE 260
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1793
Practice Address - Country:US
Practice Address - Phone:562-353-4723
Practice Address - Fax:562-353-4873
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67736183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist