Provider Demographics
NPI:1598375180
Name:PETROSYAN, ARMAN
Entity type:Individual
Prefix:
First Name:ARMAN
Middle Name:
Last Name:PETROSYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1174 N MARIPOSA AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1427
Mailing Address - Country:US
Mailing Address - Phone:323-302-3571
Mailing Address - Fax:
Practice Address - Street 1:6007 LANKERSHIM BLVD STE 7
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-4883
Practice Address - Country:US
Practice Address - Phone:818-763-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH81837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist