Provider Demographics
NPI:1457800757
Name:ABRAMYAN, IZABELLA
Entity Type:Individual
Prefix:
First Name:IZABELLA
Middle Name:
Last Name:ABRAMYAN
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 1:6100 SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2503
Mailing Address - Country:US
Mailing Address - Phone:818-989-5158
Mailing Address - Fax:818-373-5126
Practice Address - Street 1:6100 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2503
Practice Address - Country:US
Practice Address - Phone:818-989-5158
Practice Address - Fax:818-373-5126
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-27
Last Update Date:2016-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69380183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist