Healthcare Provider Details

I. General information

NPI: 1912227638
Provider Name (Legal Business Name): RAFI KHOBIARIAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 E MAGNOLIA BLVD
BURBANK CA
91502-1132
US

IV. Provider business mailing address

337 E MAGNOLIA BLVD
BURBANK CA
91502-1132
US

V. Phone/Fax

Practice location:
  • Phone: 818-260-0062
  • Fax: 818-260-0089
Mailing address:
  • Phone: 818-260-0062
  • Fax: 818-260-0089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number59674
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: