Provider Demographics
NPI:1215656319
Name:TALEBI, LADAN (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:LADAN
Middle Name:
Last Name:TALEBI
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 W ISLETA AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-9318
Mailing Address - Country:US
Mailing Address - Phone:480-678-4042
Mailing Address - Fax:
Practice Address - Street 1:1800 E RIO SALADO PKWY STE 120
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85288-2266
Practice Address - Country:US
Practice Address - Phone:480-214-2668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS025923183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist