Provider Demographics
NPI:1801183264
Name:MNATZAGANIAN, CHRISTINA LOUISE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LOUISE
Last Name:MNATZAGANIAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2747 S KIHEI RD APT J111
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7247
Mailing Address - Country:US
Mailing Address - Phone:520-331-2486
Mailing Address - Fax:
Practice Address - Street 1:34 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2056
Practice Address - Country:US
Practice Address - Phone:808-933-3861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist