Basic Information
| Provider Information | |||||||||
| NPI: | 1316942907 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REZAI | ||||||||
| FirstName: | PARASTOO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARM.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 460 OAK ST | ||||||||
| Address2: | UNIT 319 | ||||||||
| City: | GLENDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 912041265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3238232135 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 250 N ROBERTSON BLVD | ||||||||
| Address2: | STE 601 | ||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902111788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103853529 | ||||||||
| FaxNumber: | 3103853577 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2005 | ||||||||
| LastUpdateDate: | 07/15/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | 54917 | CA | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.