Provider Demographics
NPI:1265700371
Name:DADAYAN, PENAH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PENAH
Middle Name:
Last Name:DADAYAN
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 1:9401 CHIVERS AVE
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2655
Mailing Address - Country:US
Mailing Address - Phone:714-926-2216
Mailing Address - Fax:818-351-3089
Practice Address - Street 1:9401 CHIVERS AVE
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-2655
Practice Address - Country:US
Practice Address - Phone:714-926-2216
Practice Address - Fax:818-351-3089
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54557183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist