Provider Demographics
NPI:1669085429
Name:TAGAKCHYAN, TAGUHI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TAGUHI
Middle Name:
Last Name:TAGAKCHYAN
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 1:13207 COMMUNITY ST
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-3712
Mailing Address - Country:US
Mailing Address - Phone:818-303-5255
Mailing Address - Fax:
Practice Address - Street 1:531 N GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-3307
Practice Address - Country:US
Practice Address - Phone:818-241-9770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-30
Last Update Date:2020-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82923183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist