Provider Demographics
NPI:1356626667
Name:DOVLATIAN, ANAHIT ANNIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANAHIT
Middle Name:ANNIE
Last Name:DOVLATIAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 CLEVELAND RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-1007
Mailing Address - Country:US
Mailing Address - Phone:818-439-2008
Mailing Address - Fax:
Practice Address - Street 1:670 N LAKE AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1220
Practice Address - Country:US
Practice Address - Phone:626-585-8926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52887183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist