Provider Demographics
NPI:1831703503
Name:EBRAHIMI, ANABEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANABEL
Middle Name:
Last Name:EBRAHIMI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 W STOCKER ST UNIT 305
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-3558
Mailing Address - Country:US
Mailing Address - Phone:818-484-0378
Mailing Address - Fax:
Practice Address - Street 1:1030 S GLENDALE AVE STE 101
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-2866
Practice Address - Country:US
Practice Address - Phone:818-484-0378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH848183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist