Active NPI
Tanya Madelein Edinjiklian, PHARMD
- Pharmacist
- North Hollywood, CA
National Provider Identifier
1700405750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 82324
- Practice address
- 4744 Lankershim Blvd
North Hollywood, CA 91602-1833 - Phone
- (818) 505-0484
- NPI assigned
- Apr 10, 2020
- Last updated
- Nov 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 82324 | CA | Primary |
Addresses
Primary practice location
4744 Lankershim Blvd
North Hollywood, CA 91602-1833
Mailing address
12415 Stagg St
North Hollywood, CA 91605-2201
Phone (818) 388-8623
Other practice location 1
12415 Stagg St
North Hollywood, CA 91605-2201
Phone (818) 388-8623
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82324 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS LLC | Past | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1700405750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12415 STAGG ST",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916052201",
"telephone_number": "818-388-8623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4744 LANKERSHIM BLVD",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916021833",
"telephone_number": "818-505-0484"
}
],
"practiceLocations": [
{
"address_1": "12415 Stagg St",
"address_purpose": "LOCATION",
"city": "North Hollywood",
"state": "CA",
"postal_code": "916052201",
"country_code": "US",
"telephone_number": "818-388-8623",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EDINJIKLIAN",
"first_name": "TANYA",
"middle_name": "MADELEIN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-10",
"last_updated": "2020-11-04",
"certification_date": "2020-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "82324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.