Healthcare Provider Details

I. General information

NPI: 1225125917
Provider Name (Legal Business Name): SETA KASSABIAN-KAMAKIAN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 01/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 E TEMPLE ST
LOS ANGELES CA
90012-3328
US

IV. Provider business mailing address

19133 GAYLE PL
TARZANA CA
91356-5019
US

V. Phone/Fax

Practice location:
  • Phone: 213-253-5119
  • Fax:
Mailing address:
  • Phone: 818-708-1033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number41157
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: