Provider Demographics
NPI:1487216388
Name:CHARCHIAN, RENA BOYAJIAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:RENA
Middle Name:BOYAJIAN
Last Name:CHARCHIAN
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 1:1645 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-2445
Mailing Address - Country:US
Mailing Address - Phone:818-395-4917
Mailing Address - Fax:323-442-5790
Practice Address - Street 1:1510 SAN PABLO ST STE 144
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5394
Practice Address - Country:US
Practice Address - Phone:323-442-5770
Practice Address - Fax:323-442-5790
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA558581835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist