Provider Demographics
NPI:1891270971
Name:YAGOUBIAN, DANIEL (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:YAGOUBIAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 21ST ST APT A
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-3456
Mailing Address - Country:US
Mailing Address - Phone:818-802-3712
Mailing Address - Fax:
Practice Address - Street 1:11205 1/4 NATIONAL BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064
Practice Address - Country:US
Practice Address - Phone:424-297-7779
Practice Address - Fax:424-208-3221
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77563183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist