Shiv R Pertab, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH56386 Issued in CA

Practice address

2310 Telegraph Ave
Berkeley, CA 94704-1613

Phone

(510) 848-5121

Fax

(510) 848-5350

NPI assigned

Nov 14, 2011

Last updated

Nov 14, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Chevy R Pertab Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Walgreen Co

  dba Walgreens #10045

  • Pharmacy
  • Berkeley, CA
  • NPI 1295941433
  NPD (past)

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1194002469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 MARKET ST # 324",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941024801",
            "telephone_number": "510-848-5121",
            "fax_number": "510-545-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041613",
            "telephone_number": "510-848-5121",
            "fax_number": "510-848-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERTAB",
        "first_name": "SHIV",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-14",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH56386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHEVY",
            "last_name": "PERTAB",
            "middle_name": "R",
            "prefix": "MR.",
            "credential": "RPH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melinda Perlee, D.C.
• Permanente Medical Group, Inc.
• Alison Dion Perry, DO
• David W Perry, PHD
• Ron Perry, PSY.D.
• Tsipora Peskin, DSW,LCSW
• Cornelia Moura Pessoa, M.D.
• Pet-CT Imaging of Berkeley, LLC
• Carol Jean Peters, N.P.B.S.N,M.S.N
• Pamela Nicole Peters

• Pharmacist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.