Provider Demographics
NPI:1932583101
Name:HONARBAKHT, HENGAMEH
Entity Type:Individual
Prefix:
First Name:HENGAMEH
Middle Name:
Last Name:HONARBAKHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19307 SATICOY ST
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-2330
Mailing Address - Country:US
Mailing Address - Phone:818-885-1525
Mailing Address - Fax:323-295-3445
Practice Address - Street 1:19307 SATICOY ST
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-2330
Practice Address - Country:US
Practice Address - Phone:818-885-1525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH68238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist