Organization
ALTADENA MEDICAL PHARMACY INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAYANE DANIELYAN (PRESIDENT/CEO)
(626) 765-6246
Entity
Organization
Contact information
Practice address
2525 E FOOTHILL BLVD STE 6, PASADENA, CA 91107-3485
(626) 765-6246
(626) 765-6250
Mailing address
2525 E FOOTHILL BLVD STE 6, PASADENA, CA 91107-3485
(626) 765-6246
(626) 765-6250
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY59172
BOARD OF PHARMACY
CA
Enumeration date
09/05/2023
Last updated
09/05/2023
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