Provider Demographics
NPI:1336365410
Name:AMIRIAN, ANASHE (PHARMACIST)
Entity Type:Individual
Prefix:MISS
First Name:ANASHE
Middle Name:
Last Name:AMIRIAN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18356 OXNARD ST STE 1
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6706
Mailing Address - Country:US
Mailing Address - Phone:818-343-3443
Mailing Address - Fax:818-343-0933
Practice Address - Street 1:18356 OXNARD ST STE 1
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6706
Practice Address - Country:US
Practice Address - Phone:818-343-3443
Practice Address - Fax:818-343-0933
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58863183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist