Provider Demographics
NPI:1518020098
Name:SOGHOMONIAN, LENA SIMITIAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LENA
Middle Name:SIMITIAN
Last Name:SOGHOMONIAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:LENA
Other - Middle Name:SIMON
Other - Last Name:SIMITIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3834 INGLIS DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-3543
Mailing Address - Country:US
Mailing Address - Phone:323-258-1934
Mailing Address - Fax:
Practice Address - Street 1:4950 W SUNSET BLVD
Practice Address - Street 2:ROOM 280
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5822
Practice Address - Country:US
Practice Address - Phone:323-783-7250
Practice Address - Fax:323-783-0748
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40835183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist