Provider Demographics
NPI:1619221769
Name:HAKOBYAN, LEANN S (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LEANN
Middle Name:S
Last Name:HAKOBYAN
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 1:335 E AVENUE I
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-1513
Mailing Address - Country:US
Mailing Address - Phone:616-471-4100
Mailing Address - Fax:
Practice Address - Street 1:335 E AVE I
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-1513
Practice Address - Country:US
Practice Address - Phone:661-471-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-27
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68309183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA68309OtherCA BOP