Provider Demographics
NPI:1851867196
Name:LUKONINA, DARIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:DARIA
Middle Name:
Last Name:LUKONINA
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 1:5540 OWENSMOUTH AVE APT 305
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-7031
Mailing Address - Country:US
Mailing Address - Phone:818-585-8669
Mailing Address - Fax:
Practice Address - Street 1:22277 MULHOLLAND HWY
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-5156
Practice Address - Country:US
Practice Address - Phone:818-223-8656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-14
Last Update Date:2018-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist