Provider Demographics
NPI:1639623028
Name:BARAO, SYLVIA (RPH)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:BARAO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16045 NORDHOFF ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-3002
Mailing Address - Country:US
Mailing Address - Phone:818-522-4618
Mailing Address - Fax:818-768-2705
Practice Address - Street 1:8425 LAUREL CANYON BLVD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-3817
Practice Address - Country:US
Practice Address - Phone:818-768-2110
Practice Address - Fax:818-768-2705
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47235183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist