Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
REZA KHODADADI
Active Sole ProprietorREZA KHODADADI is a Long-Term Care Pharmacy healthcare provider located in SAN CLEMENTE, California. NPI 1790324978 is currently active in the NPPES registry. Verify at CMS.
Long-Term Care Pharmacy · SAN CLEMENTE, CA
Registration Details
- NPI Number
- 1790324978
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 5, 2020 (6.6252427371631 yrs)
- Last Updated
- Jan 5, 2020
- Sole Proprietor
- Yes
Practice Information
- Address
-
638 CAMINO DE LOS MARESSAN CLEMENTE, CA, 926732848Browse CA providers · Browse ZIP 92673
- Phone
- 9494879791
- Primary Specialty
-
Long-Term Care Pharmacy
3336C0003X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.