Healthcare Provider Details

I. General information

NPI: 1083195465
Provider Name (Legal Business Name): GAYANE GALAYAN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 08/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W TEHACHAPI BLVD
TEHACHAPI CA
93561-2559
US

IV. Provider business mailing address

1101 W TEHACHAPI BLVD
TEHACHAPI CA
93561-2559
US

V. Phone/Fax

Practice location:
  • Phone: 661-823-0163
  • Fax: 661-823-0742
Mailing address:
  • Phone: 661-823-0163
  • Fax: 661-823-0742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65335
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: