Provider Demographics
NPI:1033209887
Name:JAMGOTCHIAN, DIANA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:JAMGOTCHIAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19635 NASHVILLE ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-1937
Mailing Address - Country:US
Mailing Address - Phone:818-831-9953
Mailing Address - Fax:
Practice Address - Street 1:20940 BURBANK BLVD
Practice Address - Street 2:HOME INFUSION PHARMACY
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6601
Practice Address - Country:US
Practice Address - Phone:818-719-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH43673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist