Provider Demographics
NPI:1235458928
Name:MEKHJIAN, AVEDIS HAGOP (RPH)
Entity Type:Individual
Prefix:MR
First Name:AVEDIS
Middle Name:HAGOP
Last Name:MEKHJIAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1704
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91209-1704
Mailing Address - Country:US
Mailing Address - Phone:818-523-9926
Mailing Address - Fax:
Practice Address - Street 1:2006 CHILTON DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-1138
Practice Address - Country:US
Practice Address - Phone:818-523-9926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH38195183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist