Healthcare Provider Details

I. General information

NPI: 1053142448
Provider Name (Legal Business Name): ANNA KARIBYAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12100 VENTURA BLVD
STUDIO CITY CA
91604-2514
US

IV. Provider business mailing address

10804 TERECITA PL
TUJUNGA CA
91042-1445
US

V. Phone/Fax

Practice location:
  • Phone: 818-763-5562
  • Fax:
Mailing address:
  • Phone: 818-809-6103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number83447
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: