Park Compounding Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY43809 Issued in CA

Legal business name

PARK COMPOUNDING PHARMACY

Practice address

280 N Westlake Blvd
Ste 100
Westlake Village, CA 91362-3759

Phone

(805) 497-8258

Fax

(805) 497-7548

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Tony Park, PHRMD

Title

VP

Phone

(805) 497-8258

Specialties & licenses 5

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Diehl, D.C.

  • Chiropractor
  • Westlake Village, CA
  • NPI 1598857575
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1376658740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 N WESTLAKE BLVD",
            "address_2": "STE 100",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913623759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 N WESTLAKE BLVD",
            "address_2": "STE 100",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913623759",
            "telephone_number": "805-497-8258",
            "fax_number": "805-497-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK COMPOUNDING PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-08-14",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "805-497-8258",
        "authorized_official_credential": "PHRMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY43809",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0511522",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA438090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palo Alto Medical Imaging Services
• Gina Palvatana, BA
• Daphne I Panagotacos, MD
• Clifford Pang, DO
• Michael Pantiel, MSW,LCSW
• Dealie Elizabeth Park, PA
• Justine Hyoju Park, MD
• Jessica Parker, PHARMD
• Priya Sanjana Parmar, MD
• Maryam Michelle Parsaee

• Pharmacy in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; 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.