Provider Demographics
NPI:1316942907
Name:REZAI, PARASTOO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PARASTOO
Middle Name:
Last Name:REZAI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 OAK ST
Mailing Address - Street 2:UNIT 319
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1265
Mailing Address - Country:US
Mailing Address - Phone:323-823-2135
Mailing Address - Fax:
Practice Address - Street 1:250 N ROBERTSON BLVD
Practice Address - Street 2:STE 601
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1788
Practice Address - Country:US
Practice Address - Phone:310-385-3529
Practice Address - Fax:310-385-3577
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549171835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy