Provider Demographics
NPI:1154806792
Name:RAMEZANI, NAGHMEH
Entity type:Individual
Prefix:
First Name:NAGHMEH
Middle Name:
Last Name:RAMEZANI
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 1:21811 LANAR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-1041
Mailing Address - Country:US
Mailing Address - Phone:949-690-0498
Mailing Address - Fax:
Practice Address - Street 1:24330 EL TORO RD
Practice Address - Street 2:
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-2775
Practice Address - Country:US
Practice Address - Phone:949-830-0391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-29
Last Update Date:2018-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79420183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist