Provider Demographics
NPI:1659795276
Name:PILOSSYAN, SONA
Entity Type:Individual
Prefix:DR
First Name:SONA
Middle Name:
Last Name:PILOSSYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:SONA
Other - Middle Name:
Other - Last Name:PILOSYAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:20134 LEADWELL ST UNIT 302
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-4924
Mailing Address - Country:US
Mailing Address - Phone:818-517-6782
Mailing Address - Fax:
Practice Address - Street 1:20134 LEADWELL ST UNIT 302
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-4924
Practice Address - Country:US
Practice Address - Phone:818-517-6782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69412183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist