Healthcare Provider Details

I. General information

NPI: 1316819394
Provider Name (Legal Business Name): CHRISTIAN VERNON HAILOZIAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1154 PARK HILLS RD
BERKELEY CA
94708-1747
US

IV. Provider business mailing address

1154 PARK HILLS RD
BERKELEY CA
94708-1747
US

V. Phone/Fax

Practice location:
  • Phone: 510-684-7916
  • Fax:
Mailing address:
  • Phone: 510-684-7916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: