Healthcare Provider Details

I. General information

NPI: 1578842704
Provider Name (Legal Business Name): HAGOP ERIC HAGOPIAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2011
Last Update Date: 08/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6305 YORK BLVD
LOS ANGELES CA
90042-3639
US

IV. Provider business mailing address

6305 YORK BLVD
LOS ANGELES CA
90042-3639
US

V. Phone/Fax

Practice location:
  • Phone: 323-550-1317
  • Fax:
Mailing address:
  • Phone: 323-550-1317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number57497
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: