MEDICARE: DR. ARMEN TATEVOSSIAN PHARM.D

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	47251	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0578015	OTHER	CA	NABP NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598766271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARMEN TATEVOSSIAN PHARM.D

Provider Business Mailing Address
First Line	:	19500 PLUMMER ST
Second Line	:	SUITE C
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-2144
Country	:	US
Telephone Number	:	818-701-7777
Fax Number	:	818-700-4510

Provider Business Practice Location Address
First Line	:	19500 PLUMMER ST
Second Line	:	SUITE C
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-2144
Country	:	US
Telephone Number	:	818-701-7777
Fax Number	:	818-700-4510

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	04/11/2012

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