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General NPI Number Information
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NPI Number | 1134777915
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Entity Type | Individual
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Provider Name | ZORIK JOHNNY TAGMIZYAN
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Gender | Male
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Dates
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Enumeration Date | 08/26/2019
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 12660 RIVERSIDE DR
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91607-3429
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Country | US
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Telephone | 818-621-3140
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Fax |
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Provider Business Mailing Address
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Address Line | 7832 SAINT CLAIR AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-2312
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Country | US
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Telephone | 818-400-1263
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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 | 88438
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License Number State | CA
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