Provider Demographics
NPI:1407612385
Name:KHACHIAN, EMELIN S (PHARMD)
Entity Type:Individual
Prefix:
First Name:EMELIN
Middle Name:S
Last Name:KHACHIAN
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 1:10920 HILLHAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-1418
Mailing Address - Country:US
Mailing Address - Phone:818-720-2939
Mailing Address - Fax:
Practice Address - Street 1:10920 HILLHAVEN AVE
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-1418
Practice Address - Country:US
Practice Address - Phone:818-720-2939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89065183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist