Khodadadi, Reza

Khodadadi, Reza is an sole proprietor health care provider with primary practice located at 638 Camino De Los Mares , San Clemente CA 92673-2848. He recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as his primary health care specialty. Khodadadi, Reza can be contacted via phone (949) 487-9791.

Contact Information

Primary practice address
638 Camino De Los Mares San Clemente CA 92673-2848
Phone: (949) 487-9791
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1790324978
LBN Legal business name Khodadadi, Reza
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 5th, 2020
Last updated Jan 5th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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