Provider Demographics
NPI:1699551358
Name:AZIZ, IMAAN (PHARMD)
Entity type:Individual
Prefix:
First Name:IMAAN
Middle Name:
Last Name:AZIZ
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 1:4263 TIERRA REJADA RD # 198
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-3772
Mailing Address - Country:US
Mailing Address - Phone:805-915-7379
Mailing Address - Fax:
Practice Address - Street 1:591 COUNTRY CLUB DR STE C
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-7691
Practice Address - Country:US
Practice Address - Phone:805-584-2053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist