MEDICARE: DR. ANDY ANDRANIK DANAYAN

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	87493	CA
2	3336C0004X	Compounding Pharmacy	87493	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	87493	OTHER	CA	RPH

General Provider Information

NPI Number	:	1154037851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDY ANDRANIK DANAYAN

Provider Business Mailing Address
First Line	:	4128 W BURBANK BLVD
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-2121
Country	:	US
Telephone Number	:	818-697-0058
Fax Number	:

Provider Business Practice Location Address
First Line	:	4128 W BURBANK BLVD
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-2121
Country	:	US
Telephone Number	:	818-697-0058
Fax Number	:

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

Provider Enumeration Date	:	01/25/2023
Last Update Date	:	01/18/2026

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