MEDICARE: MICHAEL HAIK MUSHEGIAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	85087	CA

General Provider Information

NPI Number	:	1083376248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL HAIK MUSHEGIAN

Provider Business Mailing Address
First Line	:	417 S VIA MONTANA
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91501-1146
Country	:	US
Telephone Number	:	818-859-3818
Fax Number	:

Provider Business Practice Location Address
First Line	:	25050 PEACHLAND AVE STE 100
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91321-5764
Country	:	US
Telephone Number	:	661-255-7910
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2021
Last Update Date	:	10/06/2021

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