Missak Assadourian, PHARM. D.

Individual provider Active NPI Pharmacist · La Crescenta, CA

NPI 1437434883 · NPPES record last updated Oct 17, 2011

Key facts

NPI
1437434883
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
56154 (CA)
Practice address
3001 Foothill Blvd
La Crescenta, CA 91214-2714
Phone
(818) 541-7840
NPI assigned
Oct 17, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
56154CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 56154 CA Yes

Addresses

Primary practice location

3001 Foothill Blvd
La Crescenta, CA 91214-2714

Mailing address

3547 Mevel PL
La Crescenta, CA 91214-1143
Phone (818) 389-5830

Other providers in La Crescenta, CA

All providers in La Crescenta, CA · Pharmacist in California

Sources for this page

Verify at the official NPI Registry.