Healthcare Provider Details

I. General information

NPI: 1689205023
Provider Name (Legal Business Name): STELLA ROSE BAKMAJIAN SRB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2020
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 W GLENOAKS BLVD
GLENDALE CA
91202-2917
US

IV. Provider business mailing address

444 W GLENOAKS BLVD
GLENDALE CA
91202-2917
US

V. Phone/Fax

Practice location:
  • Phone: 818-552-3069
  • Fax:
Mailing address:
  • Phone: 818-552-3069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61313
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: