MEDICARE: TINA MARION HAROUTUNIAN PHARMD

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	77138	CA

General Provider Information

NPI Number	:	1821517301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA MARION HAROUTUNIAN PHARMD

Provider Business Mailing Address
First Line	:	10430 WILSHIRE BLVD APT 1104
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4654
Country	:	US
Telephone Number	:	801-548-7053
Fax Number	:

Provider Business Practice Location Address
First Line	:	8000 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90046-2439
Country	:	US
Telephone Number	:	323-656-1477
Fax Number	:

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

Provider Enumeration Date	:	09/15/2017
Last Update Date	:	09/15/2017

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