Provider Demographics
NPI:1225597545
Name:MARTIROSYAN, LIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LIA
Middle Name:
Last Name:MARTIROSYAN
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 1:8160 RHODES AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-1341
Mailing Address - Country:US
Mailing Address - Phone:818-691-8198
Mailing Address - Fax:
Practice Address - Street 1:8160 RHODES AVE
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-1341
Practice Address - Country:US
Practice Address - Phone:818-691-8198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-16
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77279183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist