Provider Demographics
NPI:1689950701
Name:SARAFIAN, KHATCHATUR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KHATCHATUR
Middle Name:
Last Name:SARAFIAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6608 VAN NOORD AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-1104
Mailing Address - Country:US
Mailing Address - Phone:818-800-3233
Mailing Address - Fax:
Practice Address - Street 1:10989 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-3341
Practice Address - Country:US
Practice Address - Phone:818-980-1797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66338183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist