Provider Demographics
NPI:1275531527
Name:PUZANTIAN, TALIA (PHARMD, BCPP)
Entity Type:Individual
Prefix:DR
First Name:TALIA
Middle Name:
Last Name:PUZANTIAN
Suffix:
Gender:F
Credentials:PHARMD, BCPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 WATSON DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4817
Mailing Address - Country:US
Mailing Address - Phone:909-607-0845
Mailing Address - Fax:
Practice Address - Street 1:535 WATSON DR
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4817
Practice Address - Country:US
Practice Address - Phone:909-607-0845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467491835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric