Provider Demographics
NPI:1588179428
Name:TAHMASIAN, TALIK
Entity Type:Individual
Prefix:
First Name:TALIK
Middle Name:
Last Name:TAHMASIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7223 APPERSON ST UNIT 111
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-1877
Mailing Address - Country:US
Mailing Address - Phone:818-618-6488
Mailing Address - Fax:
Practice Address - Street 1:10465 SUNLAND BLVD
Practice Address - Street 2:
Practice Address - City:SUNLAND
Practice Address - State:CA
Practice Address - Zip Code:91040-1905
Practice Address - Country:US
Practice Address - Phone:818-352-4129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist