Athenolan Pharmaceutical Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ATHENOLAN PHARMACEUTICAL INC

Practice address

16931 Bushard St
Fountain Valley, CA 92708-2819

Phone

(714) 593-5654

Fax

(714) 968-6893

NPI assigned

Apr 4, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Mahbod Zargar, PHARM DNPI 1174976914

Title

Secretary/Pic

Phone

(714) 593-5654

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• TAO WELLNESS 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.

• Mahbod Zargar

  • Pharmacist
  • Los Angeles, CA
  • NPI 1174976914
  NPD Authorized official

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569196800000",
    "number": "1174866529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16931 BUSHARD ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082819",
            "telephone_number": "714-593-5654",
            "fax_number": "714-968-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16931 BUSHARD ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082819",
            "telephone_number": "714-593-5654",
            "fax_number": "714-968-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENOLAN PHARMACEUTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-04",
        "last_updated": "2019-09-23",
        "status": "A",
        "authorized_official_last_name": "ZARGAR",
        "authorized_official_first_name": "MAHBOD",
        "authorized_official_title_or_position": "SECRETARY/PIC",
        "authorized_official_telephone_number": "714-593-5654",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY PERMIT",
            "identifier": "56916",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "56-47524",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TAO WELLNESS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TAO WELLNESS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Ashqar, PA
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• Austin Shiou Lin, M.D., Inc.

• Community/Retail Pharmacy in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.