Sahar Rezaei, PHARM.D.

Key facts

NPI

1053662718

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

63768 (CA)

Practice address

2300 Park Ave
T2151
Tustin, CA 92782-2702

Phone

(714) 361-2101

NPI assigned

Sep 20, 2012

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Pharmacy

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 20, 2012.

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1053662718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 ROSE TRELLIS",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926030172",
            "telephone_number": "714-310-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 PARK AVE",
            "address_2": "T2151",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927822702",
            "telephone_number": "714-361-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZAEI",
        "first_name": "SAHAR",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "63768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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