Provider Demographics
NPI:1194924704
Name:SHAKERANEH, HENGAMEH (PHARM D)
Entity type:Individual
Prefix:MISS
First Name:HENGAMEH
Middle Name:
Last Name:SHAKERANEH
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 1:2035 GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5717
Mailing Address - Country:US
Mailing Address - Phone:310-479-8888
Mailing Address - Fax:
Practice Address - Street 1:18356 OXNARD ST STE 1
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6706
Practice Address - Country:US
Practice Address - Phone:818-343-3443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH45821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist