Mark Shabashov, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

33172 Issued in CA

Practice address

42150 Washington St
Bermuda Dunes, CA 92203-9611

Phone

(706) 020-0084

Fax

(760) 200-0573

NPI assigned

Feb 6, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

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.

• Ralphs Grocery Company

  • Community/Retail Pharmacy
  • Bermuda Dunes, CA
  • NPI 1649295247
  NPD (past)

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1992129308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 ROYAL SAINT GEORGES WAY",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922705642",
            "telephone_number": "951-805-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42150 WASHINGTON ST",
            "city": "BERMUDA DUNES",
            "state": "CA",
            "postal_code": "922039611",
            "telephone_number": "706-020-0084",
            "fax_number": "760-200-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABASHOV",
        "first_name": "MARK",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-06",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "33172",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S007040",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Lee Roberts, M.D.
• Brandon Rosi, PT, DPT, CSCS
• Scott Russell, DO
• Scott Russell DO Inc
• Isai Serrano, LCSW
• Arif J Shaikh, M.D.
• Maridy Sherrill
• Cody Shimabukuro, DPT
• Sukhchain Singh
• Sino-US Harmony Technology Consulting Co.,LTD

• Pharmacist in Bermuda Dunes, CA
• Providers in Bermuda Dunes, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.