Provider Demographics
NPI:1578081923
Name:GEZALYAN, SOFIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SOFIA
Middle Name:
Last Name:GEZALYAN
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 1:528 E CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-3415
Mailing Address - Country:US
Mailing Address - Phone:818-397-2997
Mailing Address - Fax:
Practice Address - Street 1:528 E CEDAR AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501-3415
Practice Address - Country:US
Practice Address - Phone:818-397-2997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist