| Doctor Name: | MISS PEGAH BAZEGHI |
| NPI Number: | 1780769380 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 461912 |
| Business Practice Address: | 16111 Plummer St Sepulveda, CA - 913432036 |
| Business Phone Number: | 8188955810 |
| Business Fax Number: | 8188959378 |
| Mailing Address: | 4915 Tyrone Ave, Apt #134 SHERMAN OAKS |
| State: | CA |
| Postal Code: | 914231165 |
| Phone Number: | 8189860661 |
| Fax Number: | |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 461912 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |