Provider Demographics
NPI:1285743948
Name:TOOLAMI-VAGHEI, ASSDOLLAH (RPH, PHD)
Entity type:Individual
Prefix:DR
First Name:ASSDOLLAH
Middle Name:
Last Name:TOOLAMI-VAGHEI
Suffix:
Gender:M
Credentials:RPH, PHD
Other - Prefix:DR
Other - First Name:ASAD OR ALAN
Other - Middle Name:
Other - Last Name:TOOLAMI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH, PHD
Mailing Address - Street 1:8700 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2206
Mailing Address - Country:US
Mailing Address - Phone:310-289-6590
Mailing Address - Fax:310-289-8825
Practice Address - Street 1:8700 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2206
Practice Address - Country:US
Practice Address - Phone:310-289-6590
Practice Address - Fax:310-289-8825
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 46150183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist