Provider Demographics
NPI:1750092508
Name:KASHANIAN, SANAZ (PHARMD)
Entity type:Individual
Prefix:
First Name:SANAZ
Middle Name:
Last Name:KASHANIAN
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 1:2044 BAGLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-1102
Mailing Address - Country:US
Mailing Address - Phone:818-486-6486
Mailing Address - Fax:
Practice Address - Street 1:2044 BAGLEY AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-1102
Practice Address - Country:US
Practice Address - Phone:818-486-6486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58704183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist