Provider Demographics
NPI:1578842704
Name:HAGOPIAN, HAGOP ERIC (RPH)
Entity Type:Individual
Prefix:
First Name:HAGOP
Middle Name:ERIC
Last Name:HAGOPIAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6305 YORK BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-3639
Mailing Address - Country:US
Mailing Address - Phone:323-550-1317
Mailing Address - Fax:
Practice Address - Street 1:6305 YORK BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-3639
Practice Address - Country:US
Practice Address - Phone:323-550-1317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57497183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist