Healthcare Provider Details

I. General information

NPI: 1316542392
Provider Name (Legal Business Name): JASMIN GASPARYAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18441 VENTURA BLVD
TARZANA CA
91356-4201
US

IV. Provider business mailing address

12720 BURBANK BLVD UNIT 101
VALLEY VILLAGE CA
91607-1418
US

V. Phone/Fax

Practice location:
  • Phone: 818-996-1000
  • Fax:
Mailing address:
  • Phone: 818-815-9336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number83730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: