Healthcare Provider Details

I. General information

NPI: 1972698371
Provider Name (Legal Business Name): VERDUGO INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11914 VENTURA BLVD.
STUDIO CITY CA
91604
US

IV. Provider business mailing address

11914 VENTURA BLVD.
STUDIO CITY CA
91604
US

V. Phone/Fax

Practice location:
  • Phone: 818-761-1400
  • Fax: 818-761-1444
Mailing address:
  • Phone: 818-761-1400
  • Fax: 818-761-1444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number51837
License Number StateCA

VIII. Authorized Official

Name: MRS. ADRINE MARTIROSYAN
Title or Position: PHARMACIST
Credential: PHARM.D.
Phone: 818-761-1400