Provider Demographics
NPI:1730511619
Name:TOSSOUN, MILAD (RPH)
Entity type:Individual
Prefix:
First Name:MILAD
Middle Name:
Last Name:TOSSOUN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16911 SAN FERNANDO MISSION
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-2753
Mailing Address - Country:US
Mailing Address - Phone:818-363-8107
Mailing Address - Fax:818-831-2024
Practice Address - Street 1:16911 SAN FERNANDO MISSION
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344
Practice Address - Country:US
Practice Address - Phone:818-363-8107
Practice Address - Fax:818-831-2024
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2018-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52438183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1730511619OtherNPI