Individual provider Active NPI

Nare Petoyan, PHARM D.

  • Pharmacist
  • Tarzana, CA
National Provider Identifier
1386172963
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
756985 Issued in CA
Practice address
18455 Burbank Blvd Ste 311
Tarzana, CA 91356-6647
Phone
(818) 570-2002
Fax
(818) 570-2003
NPI assigned
May 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 756985 CA Primary

Addresses

Primary practice location

18455 Burbank Blvd Ste 311
Tarzana, CA 91356-6647

Mailing address

1611 Glenmont Dr
Glendale, CA 91207-1007
Phone (818) 399-2949

Other practice location 1

2315 Kuehner Dr Ste 108
Simi Valley, CA 93063-3960
Phone (805) 770-1003

Other practice location 2

2315 Kuehner Dr Ste 107
Simi Valley, CA 93063-3960
Phone (805) 770-1001

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
756985CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Maggie's Pharmacy Inc CurrentSince Jun 14, 2020 Accepting new patients
Allegiance Healthcare Group Inc CurrentSince Nov 29, 2020 Accepting new patients
Maggie's Pharmacy Inc CurrentSince Jun 14, 2020 Accepting new patients

Locations

2315 Kuehner Dr
Ste 107
Simi Valley, CA 93063
Phone (805) 770-1001

2315 Kuehner Dr
Ste 108
Simi Valley, CA 93063
Phone (805) 770-1003

18455 Burbank Blvd
Ste 311
Tarzana, CA 91356
Phone (818) 570-2002

Organizations & group practices 3

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": "1495756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1386172963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 GLENMONT DR",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912071007",
            "telephone_number": "818-399-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18455 BURBANK BLVD STE 311",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566647",
            "telephone_number": "818-570-2002",
            "fax_number": "818-570-2003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2315 Kuehner Dr Ste 108",
            "address_purpose": "LOCATION",
            "city": "Simi Valley",
            "state": "CA",
            "postal_code": "930633960",
            "country_code": "US",
            "telephone_number": "805-770-1003",
            "fax_number": "805-770-1004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2315 Kuehner Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "Simi Valley",
            "state": "CA",
            "postal_code": "930633960",
            "country_code": "US",
            "telephone_number": "805-770-1001",
            "fax_number": "805-770-1002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETOYAN",
        "first_name": "NARE",
        "name_prefix": "Dr.",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-26",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "756985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.