Healthcare Provider Details

I. General information

NPI: 1285388348
Provider Name (Legal Business Name): LENA NA BADALYAN PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2022
Last Update Date: 02/08/2022
Certification Date: 01/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12038 VENTURA BLVD
STUDIO CITY CA
91604-2608
US

IV. Provider business mailing address

12038 VENTURA BLVD
STUDIO CITY CA
91604-2608
US

V. Phone/Fax

Practice location:
  • Phone: 818-508-0800
  • Fax: 818-508-0012
Mailing address:
  • Phone: 818-508-0800
  • Fax: 818-508-0012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number59936
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: