Provider Demographics
NPI:1487305504
Name:BERBERIAN, NATALIE ARAXIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ARAXIE
Last Name:BERBERIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 DUNDEE DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-1211
Mailing Address - Country:US
Mailing Address - Phone:323-243-1568
Mailing Address - Fax:
Practice Address - Street 1:4407 DUNDEE DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-1211
Practice Address - Country:US
Practice Address - Phone:323-243-1568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84980183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist