=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972698371
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VERDUGO INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2006
-----------------------------------------------------
Last Update Date | 12/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11914 VENTURA BLVD.
-----------------------------------------------------
City | STUDIO CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-761-1400
-----------------------------------------------------
Fax | 818-761-1444
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11914 VENTURA BLVD.
-----------------------------------------------------
City | STUDIO CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-761-1400
-----------------------------------------------------
Fax | 818-761-1444
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST
-----------------------------------------------------
Name | MRS. ADRINE MARTIROSYAN
-----------------------------------------------------
Credential | PHARM.D.
-----------------------------------------------------
Telephone | 818-761-1400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 51837
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------