SJS RX

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SJS RX

Doing business as

Garden Plaza Pharmacy

Practice address

18411 Clark St Ste 106
Tarzana, CA 91356-3529

Phone

(818) 345-7982

Fax

(818) 345-7983

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Mitra Rastegar, PHARMDNPI 1558819250

Title

Ceo

Phone

(818) 345-7982

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Garden 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.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Mitra Rastegar, PHARM D

  • Ambulatory Care Pharmacist
  • Tarzana, CA
  • NPI 1558819250
  NPD Authorized official

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1962584748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18411 CLARK ST STE 106",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563529",
            "telephone_number": "818-345-7982",
            "fax_number": "818-345-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18411 CLARK ST STE 106",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563529",
            "telephone_number": "818-345-7982",
            "fax_number": "818-345-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJS RX",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A",
        "authorized_official_last_name": "RASTEGAR",
        "authorized_official_first_name": "MITRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-345-7982",
        "authorized_official_credential": "PHARMD"
    },
    "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
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA57452",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1993092",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Garden Plaza Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Garden Plaza Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Tarzana, CA
• Providers in Tarzana, 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 Mar 22, 2022; 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.