Provider Demographics
NPI:1083321582
Name:RADCHIK, ELIZABETH MICHELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MICHELLE
Last Name:RADCHIK
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 1:6307 SYLVIA AVE
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6609
Mailing Address - Country:US
Mailing Address - Phone:818-590-6090
Mailing Address - Fax:
Practice Address - Street 1:6307 SYLVIA AVE
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91335-6609
Practice Address - Country:US
Practice Address - Phone:818-590-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA849391835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist