Healthcare Provider Details

I. General information

NPI: 1689209538
Provider Name (Legal Business Name): LORANNA GRIGORYAN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2020
Last Update Date: 04/12/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9750 WOODMAN AVE
ARLETA CA
91331-6422
US

IV. Provider business mailing address

9750 WOODMAN AVE
ARLETA CA
91331-6422
US

V. Phone/Fax

Practice location:
  • Phone: 818-899-9950
  • Fax:
Mailing address:
  • Phone: 818-899-9950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number79552
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: