Provider Demographics
NPI:1922425693
Name:VAHAGN OVASAPYAN
Entity Type:Organization
Organization Name:VAHAGN OVASAPYAN
Other - Org Name:VAHAGN OVASAPYAN
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR OF PHARMACY
Authorized Official - Prefix:DR
Authorized Official - First Name:VAHAGN
Authorized Official - Middle Name:
Authorized Official - Last Name:OVASAPYAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:818-303-4945
Mailing Address - Street 1:2930 FAIRWAY AVE UNIT 101
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-4325
Mailing Address - Country:US
Mailing Address - Phone:818-303-4945
Mailing Address - Fax:
Practice Address - Street 1:2930 FAIRWAY AVE UNIT 101
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-4325
Practice Address - Country:US
Practice Address - Phone:818-303-4945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA631701835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Multi-Specialty