Healthcare Provider Details

I. General information

NPI: 1295213023
Provider Name (Legal Business Name): HAGOP GHARNAGHARIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2018
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 N LA BREA AVE
WEST HOLLYWOOD CA
90038-1023
US

IV. Provider business mailing address

1233 N LA BREA AVE
WEST HOLLYWOOD CA
90038-1023
US

V. Phone/Fax

Practice location:
  • Phone: 323-876-5651
  • Fax:
Mailing address:
  • Phone: 323-876-5651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number74320
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: