Provider Demographics
NPI:1447533070
Name:MARUTYAN, YULIYA
Entity type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:MARUTYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20505 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3427
Mailing Address - Country:US
Mailing Address - Phone:818-719-6599
Mailing Address - Fax:818-719-9196
Practice Address - Street 1:20505 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91306-3427
Practice Address - Country:US
Practice Address - Phone:818-719-6599
Practice Address - Fax:818-719-9196
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60667183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist