Provider Demographics
NPI:1831401280
Name:SABOUNJIAN-KOCHKARIAN, MAGGY H
Entity type:Individual
Prefix:MRS
First Name:MAGGY
Middle Name:H
Last Name:SABOUNJIAN-KOCHKARIAN
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 1:695 BURCHETT ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2808
Mailing Address - Country:US
Mailing Address - Phone:818-247-6280
Mailing Address - Fax:
Practice Address - Street 1:695 BURCHETT ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2808
Practice Address - Country:US
Practice Address - Phone:818-247-6280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11851183500000X
CA47400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist