Provider Demographics
NPI:1104555440
Name:MORIM, NAVID (PHARMD)
Entity type:Individual
Prefix:
First Name:NAVID
Middle Name:
Last Name:MORIM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12287 SUNSET PARK WAY
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-3533
Mailing Address - Country:US
Mailing Address - Phone:310-909-6491
Mailing Address - Fax:
Practice Address - Street 1:19720 VENTURA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2609
Practice Address - Country:US
Practice Address - Phone:818-912-6800
Practice Address - Fax:818-912-6989
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71890183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist