Healthcare Provider Details

I. General information

NPI: 1689950701
Provider Name (Legal Business Name): KHATCHATUR SARAFIAN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2011
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10989 VENTURA BLVD
STUDIO CITY CA
91604-3341
US

IV. Provider business mailing address

6608 VAN NOORD AVE
NORTH HOLLYWOOD CA
91606-1104
US

V. Phone/Fax

Practice location:
  • Phone: 818-980-1797
  • Fax:
Mailing address:
  • Phone: 818-800-3233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number66338
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: