Provider Demographics
NPI:1013380880
Name:REHANYAN, ANAHIT A
Entity Type:Individual
Prefix:
First Name:ANAHIT
Middle Name:A
Last Name:REHANYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20469 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3109
Mailing Address - Country:US
Mailing Address - Phone:818-668-3185
Mailing Address - Fax:818-805-3182
Practice Address - Street 1:20469 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-3109
Practice Address - Country:US
Practice Address - Phone:818-668-3185
Practice Address - Fax:818-805-3182
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-03
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60528183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist