Active NPI
Vahe Ratavousian
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1023836541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 90178
- Practice address
- 4414 York Blvd
Los Angeles, CA 90041-3328 - Phone
- (323) 344-4443
- NPI assigned
- Oct 2, 2024
- Sex
- Male
- Sole proprietor
- No
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 | 90178 | CA | Primary |
Addresses
Primary practice location
4414 York Blvd
Los Angeles, CA 90041-3328
Mailing address
1462 Andenes Dr
Glendale, CA 91208-1911
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90178 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California LLC | Past | Accepting new patients | |
| Longs Drug Store California LLC | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727827200000",
"number": "1023836541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1462 ANDENES DR",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912081911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4414 YORK BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900413328",
"telephone_number": "323-344-4443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RATAVOUSIAN",
"first_name": "VAHE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-10-02",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "90178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.