Provider Demographics
NPI:1720396260
Name:KRIKORIAN, ASPET KAREKIN (RPH)
Entity type:Individual
Prefix:
First Name:ASPET
Middle Name:KAREKIN
Last Name:KRIKORIAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:ASPET
Other - Middle Name:KAREKIN
Other - Last Name:KHACHADUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:416 W LOMITA AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1512
Mailing Address - Country:US
Mailing Address - Phone:818-247-4829
Mailing Address - Fax:
Practice Address - Street 1:416 W LOMITA AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1512
Practice Address - Country:US
Practice Address - Phone:981-824-7482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH40030183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist