Provider Demographics
NPI:1992383764
Name:POGOSYAN, LILIT (RPH)
Entity Type:Individual
Prefix:
First Name:LILIT
Middle Name:
Last Name:POGOSYAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7212 N STACIA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0311
Mailing Address - Country:US
Mailing Address - Phone:559-457-9309
Mailing Address - Fax:
Practice Address - Street 1:1506 DRAPER ST
Practice Address - Street 2:
Practice Address - City:KINGSBURG
Practice Address - State:CA
Practice Address - Zip Code:93631-1909
Practice Address - Country:US
Practice Address - Phone:559-897-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA824391835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric