Provider Demographics
NPI:1861173114
Name:HATSAKORZIAN, NANIK (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NANIK
Middle Name:
Last Name:HATSAKORZIAN
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 1:2817 ROCKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-8624
Mailing Address - Country:US
Mailing Address - Phone:818-731-7083
Mailing Address - Fax:
Practice Address - Street 1:2817 ROCKRIDGE DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-8624
Practice Address - Country:US
Practice Address - Phone:818-731-7083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70972183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist