Healthcare Provider Details

I. General information

NPI: 1952865263
Provider Name (Legal Business Name): EDWARD AGOPIAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2019
Last Update Date: 01/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25880 MCBEAN PKWY
VALENCIA CA
91355-2004
US

IV. Provider business mailing address

26043 TIERRA DR
VALENCIA CA
91355-3332
US

V. Phone/Fax

Practice location:
  • Phone: 661-254-3766
  • Fax:
Mailing address:
  • Phone: 818-268-8983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number57310
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: