Provider Demographics
NPI:1962808998
Name:VAFAKHAH, SHERMINEH
Entity type:Individual
Prefix:
First Name:SHERMINEH
Middle Name:
Last Name:VAFAKHAH
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 1:5514 LAS VIRGENES RD
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1097
Mailing Address - Country:US
Mailing Address - Phone:818-585-2029
Mailing Address - Fax:
Practice Address - Street 1:5514 LAS VIRGENES RD
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1097
Practice Address - Country:US
Practice Address - Phone:818-585-2029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist