Provider Demographics
NPI:1881733186
Name:TUMASYAN, ELENA S (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:S
Last Name:TUMASYAN
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 1:1352 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1112
Mailing Address - Country:US
Mailing Address - Phone:818-843-2552
Mailing Address - Fax:310-378-9397
Practice Address - Street 1:23451 MADISON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4763
Practice Address - Country:US
Practice Address - Phone:310-378-0005
Practice Address - Fax:310-378-9397
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55941183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist