Healthcare Provider Details

I. General information

NPI: 1093055493
Provider Name (Legal Business Name): ROMIC ESKANDARIAN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2013
Last Update Date: 08/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 N JACKSON ST 108
GLENDALE CA
91206-5325
US

IV. Provider business mailing address

616 N JACKSON ST 108
GLENDALE CA
91206-5325
US

V. Phone/Fax

Practice location:
  • Phone: 818-720-4161
  • Fax:
Mailing address:
  • Phone: 818-720-4161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number55557
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: