Provider Demographics
NPI:1962723270
Name:RAZI PHARMACY INC.
Entity type:Organization
Organization Name:RAZI PHARMACY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMBIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOJEHVAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-583-7294
Mailing Address - Street 1:23162 LOS ALISOS BLVD
Mailing Address - Street 2:SUITE 102A
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2843
Mailing Address - Country:US
Mailing Address - Phone:949-583-7294
Mailing Address - Fax:949-583-7291
Practice Address - Street 1:23162 LOS ALISOS BLVD
Practice Address - Street 2:SUITE 102A
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-2843
Practice Address - Country:US
Practice Address - Phone:949-583-7294
Practice Address - Fax:949-583-7291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY50295333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6708010001Medicare NSC