Provider Demographics
NPI:1912538919
Name:KHACHATOORIAN, NARBEH (PHARMD)
Entity Type:Individual
Prefix:
First Name:NARBEH
Middle Name:
Last Name:KHACHATOORIAN
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 1:445 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1208
Mailing Address - Country:US
Mailing Address - Phone:818-241-5996
Mailing Address - Fax:818-241-7149
Practice Address - Street 1:445 W BROADWAY
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1208
Practice Address - Country:US
Practice Address - Phone:818-241-5996
Practice Address - Fax:818-241-7149
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68516183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist