Provider Demographics
NPI:1912555707
Name:HOVHANNISYAN, EMIL (PHARMD)
Entity type:Individual
Prefix:
First Name:EMIL
Middle Name:
Last Name:HOVHANNISYAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12117 SATICOY ST.
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605
Mailing Address - Country:US
Mailing Address - Phone:747-277-1774
Mailing Address - Fax:
Practice Address - Street 1:10049 GOTHIC AVE
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-1211
Practice Address - Country:US
Practice Address - Phone:818-653-0338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89022183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty