Provider Demographics
NPI:1851710230
Name:HAROUTUNYAN, ARTASHES
Entity Type:Individual
Prefix:
First Name:ARTASHES
Middle Name:
Last Name:HAROUTUNYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 TAMARIND AVE # 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-8412
Mailing Address - Country:US
Mailing Address - Phone:323-713-0000
Mailing Address - Fax:323-467-5845
Practice Address - Street 1:14735 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403
Practice Address - Country:US
Practice Address - Phone:818-788-0208
Practice Address - Fax:818-788-6159
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist