Provider Demographics
NPI:1861124612
Name:ZAKERIASHTIANI, ELHAM (RPH)
Entity type:Individual
Prefix:
First Name:ELHAM
Middle Name:
Last Name:ZAKERIASHTIANI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11988 RANCHO BERNARDO RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2078
Mailing Address - Country:US
Mailing Address - Phone:858-322-9601
Mailing Address - Fax:
Practice Address - Street 1:11988 RANCHO BERNARDO RD UNIT A
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2078
Practice Address - Country:US
Practice Address - Phone:858-322-9601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH86167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist