PCCC Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

49817 Issued in CA

Legal business name

PCCC INC

Practice address

23101 Sherman PL
207
West Hills, CA 91307-2003

Phone

(818) 346-7222

Fax

(818) 347-7222

NPI assigned

Jan 30, 2009

Organization subpart

No

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

Authorized official

Name

Cyrus Rabizadeh

Title

Manager

Phone

(818) 346-7222

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Professional Compounding Center of California Doing business as

Locations

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1578701470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23101 SHERMAN PL",
            "address_2": "207",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913072003",
            "telephone_number": "818-346-7222",
            "fax_number": "818-347-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23101 SHERMAN PL",
            "address_2": "207",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913072003",
            "telephone_number": "818-346-7222",
            "fax_number": "818-347-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCCC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-30",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "RABIZADEH",
        "authorized_official_first_name": "CYRUS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "818-346-7222"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "49817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5633830",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Compounding Center of California",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Patricia Verda Petersen, MA, OTR/L

• Community/Retail Pharmacy in West Hills, CA
• Providers in West Hills, 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 Jun 25, 2009; 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.