Individual provider Active NPI

Pauline Gevargiz, PHARMD

  • Pharmacist
  • Tarzana, CA
National Provider Identifier
1396416509
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
84887 Issued in CA
Practice address
19110 Kittridge St Unit 7
Tarzana, CA 91335-5882
Phone
(818) 458-0073
NPI assigned
Sep 27, 2021
Last updated
Oct 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 84887 CA Primary

Addresses

Primary practice location

19110 Kittridge St Unit 7
Tarzana, CA 91335-5882

Mailing address

19110 Kittridge St Unit 7
Tarzana, CA 91335-5882
Phone (818) 458-0073

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
84887CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1396416509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19110 KITTRIDGE ST UNIT 7",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913355882",
            "telephone_number": "818-458-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19110 KITTRIDGE ST UNIT 7",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913355882",
            "telephone_number": "818-458-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEVARGIZ",
        "first_name": "PAULINE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "84887",
            "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 Oct 13, 2021; 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.