Provider Demographics
NPI:1528316759
Name:BABAKHANIAN, ANASHEH (PHARMD)
Entity type:Individual
Prefix:
First Name:ANASHEH
Middle Name:
Last Name:BABAKHANIAN
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 1:1385 E COLORADO ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1462
Mailing Address - Country:US
Mailing Address - Phone:818-242-4216
Mailing Address - Fax:818-242-4262
Practice Address - Street 1:1385 E COLORADO ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1462
Practice Address - Country:US
Practice Address - Phone:818-242-4216
Practice Address - Fax:818-242-4262
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67482183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist