Healthcare Provider Details

I. General information

NPI: 1548190911
Provider Name (Legal Business Name): OSBORNE PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21440 OSBORNE ST
CANOGA PARK CA
91304-1520
US

IV. Provider business mailing address

21440 OSBORNE ST
CANOGA PARK CA
91304-1520
US

V. Phone/Fax

Practice location:
  • Phone: 818-514-4401
  • Fax:
Mailing address:
  • Phone: 818-514-4401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: EMMA YERITSYAN
Title or Position: OWNER
Credential:
Phone: 818-514-4401