Healthcare Provider Details

I. General information

NPI: 1831057009
Provider Name (Legal Business Name): VICKEN SEVAG BARSOUMIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2026
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 SANTA FE DR
ENCINITAS CA
92024-5182
US

IV. Provider business mailing address

354 SANTA FE DR
ENCINITAS CA
92024-5182
US

V. Phone/Fax

Practice location:
  • Phone: 760-633-7640
  • Fax:
Mailing address:
  • Phone: 760-633-7640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number51477
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: