Individual provider Active NPI

Hamta Dezfoulian

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1780339531
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
84085 Issued in CA
Practice address
5837 S Central Ave
Los Angeles, CA 90001-1127
Phone
(909) 374-1025
NPI assigned
Feb 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 84085 CA Primary

Addresses

Primary practice location

5837 S Central Ave
Los Angeles, CA 90001-1127

Mailing address

6602 Torrey Pine CT
Rancho Cucamonga, CA 91739-2080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
84085CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1780339531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6602 TORREY PINE CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5837 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900011127",
            "telephone_number": "909-374-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZFOULIAN",
        "first_name": "HAMTA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "84085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.