Provider Demographics
NPI:1851673818
Name:SHAHINIAN, KEVORK SHAHE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KEVORK
Middle Name:SHAHE
Last Name:SHAHINIAN
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 1:21935 BELLA VISTA PL
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2823
Mailing Address - Country:US
Mailing Address - Phone:818-634-7091
Mailing Address - Fax:
Practice Address - Street 1:9528 TOPANGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-4011
Practice Address - Country:US
Practice Address - Phone:818-960-4664
Practice Address - Fax:818-960-4660
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist