Healthcare Provider Details

I. General information

NPI: 1891462602
Provider Name (Legal Business Name): NATALIE JESSICA MARKARYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2021
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13652 CANTARA ST
PANORAMA CITY CA
91402-5423
US

IV. Provider business mailing address

1032 ETHEL ST
GLENDALE CA
91207-1820
US

V. Phone/Fax

Practice location:
  • Phone: 866-362-4939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number92082
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: