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General NPI Number Information
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NPI Number | 1154739944
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Entity Type | Individual
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Provider Name | MAYDA YAGHSEZIAN
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Gender | Female
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Dates
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Enumeration Date | 07/24/2014
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 18251 ROSCOE BLVD # 103
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City | NORTHRIDGE
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State | CA
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Zip | 91325-4200
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Country | US
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Telephone | 818-709-5200
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Fax | 818-709-5201
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Provider Business Mailing Address
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Address Line | 17925 LAKE VISTA DR
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City | ENCINO
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State | CA
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Zip | 91316-4443
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Country | US
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Telephone | 818-458-3445
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Fax | 818-709-5201
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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 | 44326
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License Number State | CA
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