Provider Demographics
NPI:1336738970
Name:HAGOPIAN, GAYANE MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GAYANE
Middle Name:MARIE
Last Name:HAGOPIAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 RIMCREST DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91207-1044
Mailing Address - Country:US
Mailing Address - Phone:818-304-2762
Mailing Address - Fax:
Practice Address - Street 1:735 E ALTADENA DR
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-2302
Practice Address - Country:US
Practice Address - Phone:626-791-7935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-17
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83965183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist