Provider Demographics
NPI:1053169623
Name:CHORBADJIAN, SOPHIA (PHARMD)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:CHORBADJIAN
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 1:5221 RAMSDELL AVE
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-1922
Mailing Address - Country:US
Mailing Address - Phone:310-903-3903
Mailing Address - Fax:
Practice Address - Street 1:5221 RAMSDELL AVE
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-1922
Practice Address - Country:US
Practice Address - Phone:310-903-3903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85858183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist