Healthcare Provider Details

I. General information

NPI: 1881908549
Provider Name (Legal Business Name): ARUSYAK BALIKYAN DR IN PHARMACY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2010
Last Update Date: 08/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12257 RIVERSIDE DR
VALLEY VILLAGE CA
91607-3831
US

IV. Provider business mailing address

12257 RIVERSIDE DR
VALLEY VILLAGE CA
91607-3831
US

V. Phone/Fax

Practice location:
  • Phone: 818-762-3399
  • Fax:
Mailing address:
  • Phone: 818-762-3399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number54353
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: