Provider Demographics
NPI:1033707054
Name:LUVSANTSEREN, DAVAAJARGAL (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAVAAJARGAL
Middle Name:
Last Name:LUVSANTSEREN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:
Other - Last Name:LUVSANTSEREN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:14400 ADDISON ST APT 217
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-1703
Mailing Address - Country:US
Mailing Address - Phone:916-833-7221
Mailing Address - Fax:
Practice Address - Street 1:5601 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91401-4603
Practice Address - Country:US
Practice Address - Phone:818-781-0569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA810381835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory CareGroup - Single Specialty