Provider Demographics
NPI:1467044255
Name:BALIAN, TATIANA ALIN
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:ALIN
Last Name:BALIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALIN
Other - Middle Name:TATIANA
Other - Last Name:BALIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11801 TURTLE SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-4026
Mailing Address - Country:US
Mailing Address - Phone:818-433-9607
Mailing Address - Fax:
Practice Address - Street 1:18020 CHATSWORTH ST
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5607
Practice Address - Country:US
Practice Address - Phone:818-831-4152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician