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General NPI Number Information
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NPI Number | 1467115105
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Entity Type | Individual
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Provider Name | ARMEN AYVAZYAN
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Gender | Male
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 10/20/2021
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Provider Practice Location Address
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Address Line | 9725 LAUREL CANYON BLVD
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City | ARLETA
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State | CA
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Zip | 91331-4100
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Country | US
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Telephone | 818-492-0025
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Fax |
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Provider Business Mailing Address
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Address Line | 630 E GARFIELD AVE APT 14
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City | GLENDALE
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State | CA
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Zip | 91205-2970
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Country | US
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Telephone |
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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 | 85395
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License Number State | CA
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