MEDICARE: EMAN JAVAHERIAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	69797	CA
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	69797	CA

General Provider Information

NPI Number	:	1093120180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMAN JAVAHERIAN

Provider Business Mailing Address
First Line	:	17441 HATTERAS ST
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-1313
Country	:	US
Telephone Number	:	818-421-1373
Fax Number	:

Provider Business Practice Location Address
First Line	:	17441 HATTERAS ST
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-1313
Country	:	US
Telephone Number	:	818-421-1373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2014
Last Update Date	:	06/03/2026

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