Provider Demographics
NPI:1093885006
Name:KNADZYAN, ARUSYAK
Entity Type:Individual
Prefix:
First Name:ARUSYAK
Middle Name:
Last Name:KNADZYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5454 ZELZAH AVE
Mailing Address - Street 2:#311
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316
Mailing Address - Country:US
Mailing Address - Phone:818-284-1188
Mailing Address - Fax:323-664-1809
Practice Address - Street 1:5137 1/2 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LA
Practice Address - State:CA
Practice Address - Zip Code:90027
Practice Address - Country:US
Practice Address - Phone:323-664-1882
Practice Address - Fax:323-664-1809
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26978183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician