Healthcare Provider Details

I. General information

NPI: 1689505737
Provider Name (Legal Business Name): SAN FERNANDO PHARMACY INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 N MACLAY AVE UNIT A
SAN FERNANDO CA
91340-2137
US

IV. Provider business mailing address

2155 VERDUGO BLVD # 907
MONTROSE CA
91020-1628
US

V. Phone/Fax

Practice location:
  • Phone: 818-867-3006
  • Fax: 818-867-3007
Mailing address:
  • Phone: 818-867-3006
  • Fax: 818-867-3007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MS. LUSINE SARGSYAN
Title or Position: OWNER/CEO
Credential: PHARMD
Phone: 213-327-5946