Provider Demographics
NPI:1508238429
Name:DEMERJIAN, AIDA (PHARMD)
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:
Last Name:DEMERJIAN
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 1:1820 W VERDUGO AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2150
Mailing Address - Country:US
Mailing Address - Phone:818-845-9332
Mailing Address - Fax:818-567-4912
Practice Address - Street 1:1820 W VERDUGO AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2150
Practice Address - Country:US
Practice Address - Phone:818-845-9332
Practice Address - Fax:818-567-4912
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH61474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist