REZA KHODADADI (NPI# 1790324978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790324978 |
| Entity Type | Individual |
| Full Name | REZA KHODADADI |
| Practice Address |
638 Camino De Los Mares San Clemente CA 92673-2848 |
| Mailing Address |
17252 Chestnut Irvine CA 92612-2351 |
| Practice Telephone | 9494879791 |
| Enumeration Date | 2020-01-05 |
| Last Update Date | 2020-01-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Street Address |
638 CAMINO DE LOS MARES |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92673-2848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922042274 | Garfield Beach Cvs LLC | Pharmacy | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2006-06-16 |
| 1225677628 | Samey Abdulrub | Pharmacist | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2020-01-02 |
| 1194291096 | Victoria Deangelo | Pharmacist | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2018-10-17 |
| 1083116586 | Victoria Lynn Whalen | Nurse Practitioner | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2018-03-01 |
| 1821527110 | Sima Patel | Pharmacist | 638 Camino De Los Mares, San Clemente, CA 92673 | 2017-06-08 |
| 1093242851 | Sonia Gordon Luckey | Nurse Practitioner | 638 Camino De Los Mares, San Clemente, CA 92673 | 2017-05-11 |
| 1780119289 | Stephanie Chiu | Pharmacist | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2017-04-22 |
| 1003347816 | Katarzyna Anna Hudson | Nurse Practitioner | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2017-03-23 |
| 1205253002 | Home Sleep Partners | Clinical Medical Laboratory | 638 Camino De Los Mares, Suite H130-600, San Clemente, CA 92673-2848 | 2014-03-19 |
| 1306071055 | Jean M Lim Optometry, Inc | Optometrist | 638 Camino De Los Mares, A120, San Clemente, CA 92673-2848 | 2009-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497246474 | Cynthia Hull Warren | Nutritionist | 2027 Via Concha, San Clemente, CA 92673 | 2018-05-24 |
| 1063942688 | Trinh T Tran | Pharmacist | 638 Camino De Los Mares #d5, San Clemente, CA 92673 | 2017-06-15 |
| 1427421791 | Jessica A Currens | Nurse Practitioner | 1001 Avenida Pico Ste C517, San Clemente, CA 92673 | 2015-11-08 |
| 1184010647 | Garrett Bryon Rubio | Student in an Organized Health Care Education/Training Program | 905 Calle Amanecer Ste. 265, San Clemente, CA 92673 | 2015-04-11 |
| 1255733853 | Body Mind Spirit Iop Inc | Psychologist | 665 Camino De Los Mares Ste 104, San Clemente, CA 92673 | 2014-09-25 |
| 1548677438 | Jessica Ann Riley | Dermatology | 1300 Avenida Vista Hermosa Ste 150, San Clemente, CA 92673 | 2014-07-13 |
| 1427398718 | Veena Menda | Specialist | 2232 Calle Opalo, San Clemente, CA 92673 | 2013-02-22 |
| 1124383781 | Alexandra Rose Corporation | Substance Abuse Rehabilitation Facility | 4009 Calle Abril, San Clemente, CA 92673 | 2012-07-10 |
| 1457612574 | Noelle J Deckman | Psychologist | 629 Camino De Los Mares Ste 207a, San Clemente, CA 92673 | 2012-06-05 |
| 1851686471 | Meighan Bartholomew Merono | Pharmacist | 990 Avenida Vista Hermosa, San Clemente, CA 92673 | 2011-06-10 |
| Find all providers in zip 92673 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407035355 | Ralphs Grocery Company | Pharmacy | 811 Avenida Talega, San Clemente, CA 92673-6523 | 2007-10-29 |
| 1740392679 | R & K Lombard Pharmacy Corp. | Pharmacy | 1001 S El Camino Real Ste A, San Clemente, CA 92672-4284 | 2006-08-31 |
| 1902841802 | Garfield Beach Cvs LLC | Pharmacy | 602 N El Camino Real, San Clemente, CA 92672-4720 | 2006-06-17 |
| 1922042274 | Garfield Beach Cvs LLC | Pharmacy | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2006-06-16 |
| 1700258746 | Savon #6563 | Pharmacy | 989 Avenida Pico, San Clemente, CA 92673-3908 | 2015-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689987 | Capsule San Diego LLC | Pharmacy | 1450 Columbia St Ste B, San Diego, CA 92101-3487 | 2020-11-04 |
| 1023618824 | Ingram's Pharmacy, LLC | Pharmacy | 1115 Union Ave Unit 147-1c, Bakersfield, CA 93307-1050 | 2020-10-29 |
| 1750981874 | Capsule San Francisco LLC | Pharmacy | 475 University Ave, Palo Alto, CA 94301-1814 | 2020-10-28 |
| 1447850623 | Sterling Hatteras LLC | Pharmacy | 916 E Cypress Ave Ste 300, Redding, CA 96002-1038 | 2020-10-28 |
| 1922608454 | Vanessa Ann Marie Rita Pitts | Pharmacy | 26365 Buccaneer Ln, Helendale, CA 92342-7739 | 2020-10-26 |
| 1205435971 | Rinaldi Pharmacy, Inc. | Pharmacy | 11237 Tampa Ave, Porter Ranch, CA 91326-1610 | 2020-10-22 |
| 1467051300 | San Dimas Wellness Pharmacy | Pharmacy | 830 W Arrow Hwy Ste 830b, San Dimas, CA 91773-2498 | 2020-10-21 |
| 1225636889 | Med-plus Pharmacy Inc | Pharmacy | 335 Lindbergh Ave, Livermore, CA 94551-9291 | 2020-10-15 |
| 1689271066 | Innova Pharmacy Iv | Pharmacy | 4815 Watt Ave Ste B101, North Highlands, CA 95660-5108 | 2020-10-08 |
| 1114524683 | Bear Valley Pharmacy | Pharmacy | 17003 Bear Valley Rd Ste B, Hesperia, CA 92345-1420 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
| City | SAN CLEMENTE |
| Zip Code | 92673 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.