Provider Demographics
NPI:1013237932
Name:AREVALO, KARENINA JULIAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KARENINA
Middle Name:JULIAN
Last Name:AREVALO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KARENINA
Other - Middle Name:G
Other - Last Name:JULIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13633 CORNUTA AVE
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-2507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7900 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-3304
Practice Address - Country:US
Practice Address - Phone:323-876-4466
Practice Address - Fax:323-876-0635
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist