Healthcare Provider Details
I. General information
NPI: 1447832357
Provider Name (Legal Business Name): ARMEN KARO FSTKCHIAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/21/2021
Last Update Date: 04/24/2021
Certification Date: 04/24/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
24745 STEWART ST
LOMA LINDA CA
92350-1719
US
IV. Provider business mailing address
1271 E PENNSYLVANIA AVE
REDLANDS CA
92374-4707
US
V. Phone/Fax
- Phone: 909-558-7587
- Fax:
- Phone: 818-212-8951
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | RPH82813 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: