Provider Demographics
NPI:1427729144
Name:JAVAHERIAN, RAHA
Entity type:Individual
Prefix:
First Name:RAHA
Middle Name:
Last Name:JAVAHERIAN
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 1:9669 BRIGHTON WAY
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5125
Mailing Address - Country:US
Mailing Address - Phone:424-335-0755
Mailing Address - Fax:
Practice Address - Street 1:9669 BRIGHTON WAY
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5125
Practice Address - Country:US
Practice Address - Phone:424-335-0755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59062183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist