Provider Demographics
NPI:1811602071
Name:BOYNAGIRYAN, VAHRAM (PHARMD)
Entity type:Individual
Prefix:
First Name:VAHRAM
Middle Name:
Last Name:BOYNAGIRYAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12450 MAGNOLIA BLVD # 4063
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-2451
Mailing Address - Country:US
Mailing Address - Phone:818-738-4861
Mailing Address - Fax:
Practice Address - Street 1:330 N BRAND BLVD STE 155
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2324
Practice Address - Country:US
Practice Address - Phone:800-557-5555
Practice Address - Fax:800-557-9095
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH87533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist