Olympia Plaza Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY48416 Issued in CA

Legal business name

OLYMPIA PLAZA PHARMACY INC

Practice address

5901 W Olympic Blvd
Suite 103
Los Angeles, CA 90036-4667

Phone

(323) 937-2590

Fax

(323) 937-0259

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Tatyana Borokhovich, RPH

Title

Pic

Phone

(323) 937-2590

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• OLYMPIA PLAZA PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 4

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

• Emil Borokhovich

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1649971839
  NPD
• Araz Raffi Nazarian, PHARMD

  • Pharmacist
  • Los Angeles, CA
  • NPI 1972268621
  NPD (past)
• Joshua Noel Thorburn, PHARMD

  • Pharmacist
  • Los Angeles, CA
  • NPI 1720464084
  NPD (past)
• Huong Tran

  • Pharmacist
  • Los Angeles, CA
  • NPI 1518416478
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346716800000",
    "number": "1477615003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 W OLYMPIC BLVD",
            "address_2": "SUITE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364667",
            "telephone_number": "323-937-2590",
            "fax_number": "323-937-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 W OLYMPIC BLVD",
            "address_2": "SUITE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364667",
            "telephone_number": "323-937-2590",
            "fax_number": "323-937-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIA PLAZA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2012-09-04",
        "status": "A",
        "authorized_official_last_name": "BOROKHOVICH",
        "authorized_official_first_name": "TATYANA",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "323-937-2590",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY48416",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "CA",
            "license": "PHY 48416",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0597902",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477615003",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OLYMPIA PLAZA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sylvia Vanessa Olvera, M.D.
• Mojtaba Olyaie, M.D
• Olympia Health Care LLC
• Olympia MSC Kim Chiropractic, Inc.
• Olympia Physical Therapy and Performance Inc
• Olympic Imaging Services
• Olympic Imaging Services
• Olympic Rehabilitation Adhc, Site II
• Olympic Rehabilitation Center
• Olympic Rehabilitation Center, Inc

• Community/Retail Pharmacy in Los Angeles, CA
• Providers in Los Angeles, 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 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.