Peticub

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PETICUB

Practice address

1804 S la Cienega Blvd # 102
Los Angeles, CA 90035-4670

Phone

(310) 839-7387

Fax

(310) 288-9141

NPI assigned

Jun 27, 2012

Organization subpart

No

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

Authorized official

Name

Rabin Shaoulian

Title

Location Manager

Phone

(310) 839-7387

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Peticub Doing business as

Locations

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345507200000",
    "number": "1790049484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 S LA CIENEGA BLVD # 102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900354670",
            "telephone_number": "310-839-7387",
            "fax_number": "310-288-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 S LA CIENEGA BLVD # 102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900354670",
            "telephone_number": "310-839-7387",
            "fax_number": "310-288-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETICUB",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-27",
        "last_updated": "2012-08-21",
        "status": "A",
        "authorized_official_last_name": "SHAOULIAN",
        "authorized_official_first_name": "RABIN",
        "authorized_official_title_or_position": "LOCATION MANAGER",
        "authorized_official_telephone_number": "310-839-7387"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5644821",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peticub",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Peterson
• Porsha Peterson, NP
• Robert Phillip Sims Peterson
• Ryan Curtis Peterson, M.D.
• Sara Peterson, PT, DPT
• Nubar Petikyan, PHARMD
• Sharlette Renee Petillo
• Brandi-Lynn Petit
• Kathryn H Petit
• Claude Joseph Petite, LCSW

• 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 Aug 21, 2012; 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.