MEDICARE: ANET MINASSIAN

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	78073	CA

General Provider Information

NPI Number	:	1518473669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANET MINASSIAN

Provider Business Mailing Address
First Line	:	554 PALM DR
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2827
Country	:	US
Telephone Number	:	818-669-8622
Fax Number	:

Provider Business Practice Location Address
First Line	:	554 PALM DR
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2827
Country	:	US
Telephone Number	:	818-669-8622
Fax Number	:

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

Provider Enumeration Date	:	12/26/2017
Last Update Date	:	12/26/2017

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Directions to “ ANET MINASSIAN ” Practice Location

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