Most Relevant Information
Provider Data
| NPI Number: | 1003524703 |
| Provider Name: | SHANNON BAHARI MOGHADAM PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 86887 |
Most Important Dates
| Enumeration Date: | 11/10/2022 |
| Last Updated: | 11/10/2022 |
Provider Practice Location
9045 WILSHIRE BLVD
BEVERLY HILLS
CA
902111829
Practice Location Phone/Fax
| Phone: | 3102735252 |
| Fax: |
Provider Mailing Location
10660 WILSHIRE BLVD APT 310
LOS ANGELES
CA
900244523
Provider Mailing Phone/Fax
| Phone: | 4242302122 |
| Fax: |