Tahoe City Plaza Pharmacy

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PHY 43340 Issued in CA

Legal business name

TAHOE CITY PLAZA PHARMACY

Doing business as

tahoe city compounding pharmacy

Practice address

599 North Lake Blvd
Tahoe City, CA 96145-7229

Phone

(530) 583-3888

Fax

(530) 583-1301

NPI assigned

Dec 1, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gary P Sabistina, RPHNPI 1508279597

Title

Pharmacist

Phone

(530) 583-3888

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• tahoe city compounding pharmacy Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gary Sabistina, RPH

  • Pharmacist
  • Tahoe City, CA
  • NPI 1508279597
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1134297906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7229",
            "city": "TAHOE CITY",
            "state": "CA",
            "postal_code": "961457229",
            "telephone_number": "530-583-3888",
            "fax_number": "530-583-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 NORTH LAKE BLVD",
            "city": "TAHOE CITY",
            "state": "CA",
            "postal_code": "961457229",
            "telephone_number": "530-583-3888",
            "fax_number": "530-583-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAHOE CITY PLAZA PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "SABISTINA",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "530-583-3888",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "CA",
            "license": "PHY 43340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETAIL PHARMACY PERMIT",
            "identifier": "PHY 43340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "tahoe city compounding pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan E Ganong Shirley, PA-C, MPA
• Sierra Mental Wellness Group
• Mark Harrison Spohr, M.D.
• Lisa Stekert, LCSW
• Tahoe City Dental Group
• Tahoe Forest Hospital District
• Diane Lynn Thelen, RN
• Richard R Tomlinson, DDS
• Truckee Tahoe Medical Group
• Todd Trujillo, PT

• Compounding Pharmacy in Tahoe City, CA
• Providers in Tahoe City, CA by specialty
• Compounding Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.