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General NPI Number Information
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NPI Number | 1053814012
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Entity Type | Individual
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Provider Name | ANNA AKAYVAN PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 03/15/2018
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Last Update Date | 03/15/2018
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Provider Practice Location Address
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Address Line | 1150 BROADWAY
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City | CHULA VISTA
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State | CA
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Zip | 91911-2707
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Country | US
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Telephone | 858-212-1137
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Fax |
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Provider Business Mailing Address
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Address Line | 5169 CATOCTIN DR
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City | SAN DIEGO
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State | CA
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Zip | 92115-1518
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Country | US
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Telephone | 858-212-1137
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 67058
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 67058
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 67058
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 67058
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License Number State | CA
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