PETICUB (NPI# 1790049484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790049484 |
| Entity Type | Organization |
| Organization Name | PETICUB |
| Other Organization Name | PETICUB |
| Practice Address |
1804 S La Cienega Blvd # 102 Los Angeles CA 90035-4670 |
| Practice Telephone | 3108397387 |
| Practice Fax Number | 3102889141 |
| Mailing Telephone | 3108397387 |
| Mailing Fax Number | 3102889141 |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2012-08-21 |
| Authorized Official Name | RABIN SHAOULIAN (LOCATION MANAGER) |
| Authorized Official Telephone | 3108397387 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
Suppliers | ||
| N | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 5644821 | 01 |
| Other Name | Type Code |
|---|---|
| Peticub | Doing Business As Name - Organization |
| Street Address |
1804 S LA CIENEGA BLVD # 102 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90035-4670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871122606 | Transformational Yoga, LLC | Chiropractor | 1649 Robertson Blvd, Los Angeles, CA 90035 | 2020-04-03 |
| 1962061945 | Alcott Center for Mental Health Services | Community/Behavioral Health | 1441-1443 S. Robertson Blvd., Los Angeles, CA 90035 | 2019-06-12 |
| 1124514773 | Bahareh Haykani | Physician Assistant | 1105 S La Peer Dr, Los Angeles, CA 90035 | 2018-07-06 |
| 1700303609 | Jisun Lee | Specialist/Technologist | 1080 S. La Cienega Blvd, #208, Los Angeles, CA 90035 | 2017-08-23 |
| 1407202393 | Elham Azarmiazam | Chiropractor | 1016 South Robertson Blvd., Los Angeles, CA 90035 | 2016-05-10 |
| 1548626369 | Esther Levy-bremer | Acupuncturist | 1411 S. Cardiff Ave., Ca 90035, Los Angeles, CA 90035 | 2016-01-08 |
| 1972992949 | Tali Shams | Pharmacist | 1108 South Lapeer Drive, Los Angeles, CA 90035 | 2015-01-14 |
| 1932598067 | Edwin Gromis | Orthopaedic Surgery | 1122 South Robertson Blvd., Los Angeles, CA 90035 | 2015-01-13 |
| 1437568250 | Edwin Gromis M.d. A Prof Corp | Orthopaedic Surgery | 1122 S. Robertson Blvd Suite 1, Los Angeles, CA 90035 | 2014-08-06 |
| 1073929725 | David Javdon | Dentist | 1125 S. Beverly Dr., Suite #400, Los Angeles, CA 90035 | 2014-07-02 |
| Find all providers in zip 90035 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265040836 | Cmc Enterprise, Inc. | Pharmacy | 2426 W 8th St Ste 112, Los Angeles, CA 90057-3840 | 2020-07-20 |
| 1538782230 | Altamed Health Services Corp | Pharmacy | 3945 Whittier Blvd Rm 100, Los Angeles, CA 90023-2440 | 2020-05-28 |
| 1184243602 | Dtla Rx Pharmacy Apc | Pharmacy | 1120 S Grand Ave Ste 103, Los Angeles, CA 90015-4677 | 2020-04-14 |
| 1700405701 | Altamed Health Services Corp | Pharmacy | 972 Goodrich Blvd Rm 100, Los Angeles, CA 90022 | 2020-04-10 |
| 1649807140 | Mixlab, Inc. | Pharmacy | 2223 Federal Ave, Los Angeles, CA 90064-1403 | 2020-03-25 |
| 1457985426 | Care Prescription Management | Pharmacy | 5757 Wilshire Blvd Ste 320, Los Angeles, CA 90036-3686 | 2020-02-27 |
| 1609409077 | Altamed Health Services Corp | Pharmacy | 2100 W 3rd St Ste 190, Los Angeles, CA 90057-1999 | 2020-02-13 |
| 1003448184 | Linco Pharmacy, Inc. | Pharmacy | 5755 W Adams Blvd, Los Angeles, CA 90016-2440 | 2020-02-06 |
| 1972149292 | Cedars-sinai Medical Care Foundation | Pharmacy | 11800 Wilshire Blvd Ste 202, Los Angeles, CA 90025-6602 | 2019-11-21 |
| 1659930089 | Jade Kalelei Wilia | Pharmacy | 1411 N Mansfield Ave Apt 9, Los Angeles, CA 90028-7676 | 2019-06-10 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90035 |
Please comment or provide details below to improve the information on PETICUB.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.