Provider Demographics
NPI:1528651486
Name:KOLANGIAN, ANI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANI
Middle Name:
Last Name:KOLANGIAN
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 1:5112 HOLLYWOOD BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6124
Mailing Address - Country:US
Mailing Address - Phone:323-913-3337
Mailing Address - Fax:
Practice Address - Street 1:13021 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-2925
Practice Address - Country:US
Practice Address - Phone:818-760-2861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82718183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist