Provider Demographics
NPI:1750993226
Name:ASSADVAZADORIAN, CHRISTINA ARSHO
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ARSHO
Last Name:ASSADVAZADORIAN
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 1:9414 CORDERO AVE
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-3302
Mailing Address - Country:US
Mailing Address - Phone:818-802-6528
Mailing Address - Fax:
Practice Address - Street 1:5451 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5613
Practice Address - Country:US
Practice Address - Phone:323-860-7970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80616183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist