S Amir Farzan Tavakkoli Isfahani

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

S AMIR FARZAN TAVAKKOLI ISFAHANI

Doing business as

Laguna Niguel HealthMart Pharmacy

Practice address

27871 La Paz Rd
Laguna Niguel, CA 92677-3920

Phone

(949) 360-1600

NPI assigned

Jun 30, 2015

Last updated

Jul 7, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Seid Amir Farzan Tavakkoli Isfahani

Title

Owner

Phone

(256) 797-2552

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Laguna Niguel HealthMart Pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1164805875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27871 LA PAZ RD",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926773920",
            "telephone_number": "949-360-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27871 LA PAZ RD",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926773920",
            "telephone_number": "949-360-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S AMIR FARZAN TAVAKKOLI ISFAHANI",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-30",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "TAVAKKOLI ISFAHANI",
        "authorized_official_first_name": "SEID AMIR FARZAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-797-2552"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152883",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laguna Niguel HealthMart Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.