Provider Demographics
NPI:1639283773
Name:HARTOUNIAN, RAFFI G (RPH)
Entity Type:Individual
Prefix:MR
First Name:RAFFI
Middle Name:G
Last Name:HARTOUNIAN
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:PO BOX 567
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90608-0567
Mailing Address - Country:US
Mailing Address - Phone:562-692-4278
Mailing Address - Fax:562-692-7149
Practice Address - Street 1:11120 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-1432
Practice Address - Country:US
Practice Address - Phone:562-692-4278
Practice Address - Fax:562-692-7149
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA40803OtherPHARMACIST LICENSE