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NPI Code Detail

MEDICARE: TINA ANI BGDOIAN

MEDICARE: TINA ANI BGDOIAN
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
1183500000XPharmacist81306CA

General Provider Information

NPI Number : 1356988570
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA ANI BGDOIAN
Provider Business Mailing Address
First Line : 8082 N MAROA AVE APT 201
Second Line :
City : FRESNO
State : CA
Zip : 93711-6124
Country : US
Telephone Number : 818-454-3036
Fax Number :
Provider Business Practice Location Address
First Line : 2020 E COPPER AVE
Second Line :
City : FRESNO
State : CA
Zip : 93730-5402
Country : US
Telephone Number : 818-454-3036
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2019
Last Update Date : 12/06/2019

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Directions to “ TINA ANI BGDOIAN ” Practice Location

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