Provider Demographics
NPI:1780084343
Name:KESHISHIAN, LUSINEH (PHARMD)
Entity type:Individual
Prefix:
First Name:LUSINEH
Middle Name:
Last Name:KESHISHIAN
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 1:10711 MOUNT GLEASON AVE
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-2526
Mailing Address - Country:US
Mailing Address - Phone:818-804-1406
Mailing Address - Fax:
Practice Address - Street 1:10711 MOUNT GLEASON AVE
Practice Address - Street 2:
Practice Address - City:SUNLAND
Practice Address - State:CA
Practice Address - Zip Code:91040-2526
Practice Address - Country:US
Practice Address - Phone:818-804-1406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-01
Last Update Date:2014-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist