Provider Demographics
NPI:1386172963
Name:PETOYAN, NARE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:NARE
Middle Name:
Last Name:PETOYAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 GLENMONT DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91207-1007
Mailing Address - Country:US
Mailing Address - Phone:818-399-2949
Mailing Address - Fax:
Practice Address - Street 1:18455 BURBANK BLVD STE 311
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6647
Practice Address - Country:US
Practice Address - Phone:818-570-2002
Practice Address - Fax:818-570-2003
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA756985183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist