Healthcare Provider Details

I. General information

NPI: 1093692451
Provider Name (Legal Business Name): SHANT KRIKORIAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18300 ROSCOE BLVD
NORTHRIDGE CA
91325-4167
US

IV. Provider business mailing address

16544 KALISHER ST
GRANADA HILLS CA
91344-3777
US

V. Phone/Fax

Practice location:
  • Phone: 818-885-8500
  • Fax:
Mailing address:
  • Phone: 818-427-2243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH90274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: