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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 56154 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in La Crescenta, CA · Pharmacist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.