Individual provider Active NPI

Nooshin Amirtabar, PHARMD

  • Pharmacist
  • Glendale, CA
National Provider Identifier
1942948815
Registry record updated May 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
85459 Issued in CA
Practice address
721 E Broadway Ste 101
Glendale, CA 91205-4951
Phone
(818) 396-4818
Fax
(818) 396-4816
NPI assigned
May 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 85459 CA Primary

Addresses

Primary practice location

721 E Broadway Ste 101
Glendale, CA 91205-4951

Mailing address

5019 Saunders Cir
Temple City, CA 91780-3310
Phone (949) 228-3619

Other names 1

  • Dr. Nooshin Amirtabar Arabi Former name

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
85459CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Olympic Community Pharmacy Inc CurrentSince May 29, 2022 Accepting new patients

Locations

721 E Broadway
Ste 101
Glendale, CA 91205
Phone (818) 396-4818

Organizations & group practices 1

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": "1653091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653091200000",
    "number": "1942948815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5019 SAUNDERS CIR",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917803310",
            "telephone_number": "949-228-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 E BROADWAY STE 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054951",
            "telephone_number": "818-396-4818",
            "fax_number": "818-396-4816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIRTABAR",
        "first_name": "NOOSHIN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-21",
        "last_updated": "2022-05-21",
        "certification_date": "2022-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "85459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOOSHIN",
            "last_name": "AMIRTABAR ARABI",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2022; 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.