Healthcare Provider Details

I. General information

NPI: 1124563457
Provider Name (Legal Business Name): NARINEH AWANESSI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2016
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18300 ROSCOE BLVD
NORTHRIDGE CA
91325-4105
US

IV. Provider business mailing address

1918 AMBER LN
BURBANK CA
91504-1903
US

V. Phone/Fax

Practice location:
  • Phone: 818-885-8500
  • Fax: 818-700-5690
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number67098
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: