Provider Demographics
NPI:1689760530
Name:OKUMYANSKY, YEVGENY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:YEVGENY
Middle Name:
Last Name:OKUMYANSKY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:EUGENE
Other - Middle Name:
Other - Last Name:OKUMYANSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:722 N SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90038-3312
Mailing Address - Country:US
Mailing Address - Phone:323-954-1025
Mailing Address - Fax:323-954-9573
Practice Address - Street 1:4867 W SUNSET BLVD
Practice Address - Street 2:INPATIENT PHARMACY
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5969
Practice Address - Country:US
Practice Address - Phone:323-783-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00057643183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist