TIRAK TOM SHAFA (NPI# 1114901014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114901014 |
| Entity Type | Organization |
| Organization Name | TIRAK TOM SHAFA |
| Other Organization Name | MID WEST MEDICAL PHARMACY |
| Practice Address |
8733 Beverly Blvd Ste 100 West Hollywood CA 90048-1890 |
| Practice Telephone | 3106571635 |
| Practice Fax Number | 3106575455 |
| Mailing Telephone | 3106571635 |
| Mailing Fax Number | 3106575455 |
| Enumeration Date | 2005-12-04 |
| Last Update Date | 2016-08-16 |
| Authorized Official Name | TOM SHAFA (OWNER, PIC, AO) |
| Authorized Official Telephone | 3106571635 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY22051 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2002290 | 01 | |
| CA | PHA220510 | 05 |
| Other Name | Type Code |
|---|---|
| MID WEST MEDICAL PHARMACY | Doing Business As Name - Organization |
| Street Address |
8733 BEVERLY BLVD STE 100 |
| City | WEST HOLLYWOOD |
| State | CA |
| Zip Code | 90048-1890 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326414756 | Denise Marie Moore | Nurse Practitioner | 8733 Beverly Blvd, Suite 408, West Hollywood, CA 90048-1827 | 2015-08-20 |
| 1114356789 | Joanna Josue | Nurse Practitioner | 8733 Beverly Blvd, Suite 408, West Hollywood, CA 90048-1827 | 2013-11-05 |
| 1740617174 | Lisa R Hughes | Nurse Practitioner | 8733 Beverly Blvd, Suite 200, West Hollywood, CA 90048-1827 | 2013-09-30 |
| 1649615881 | Annahita Pourmand | Internal Medicine | 8733 Beverly Blvd, Suite 408, West Hollywood, CA 90048-1827 | 2013-05-01 |
| 1790033116 | Andrew E. Hendifar,m.d. A Medical Corporation | Internal Medicine | 8733 Beverly Blvd, Suite 408, West Hollywood, CA 90048-1827 | 2012-08-15 |
| 1619224557 | Jane Y Kauffman, Md, PC | Specialist | 8733 Beverly Blvd, Suite 312, West Hollywood, CA 90048-1827 | 2012-08-09 |
| 1275807968 | Jerome Lipin | Pediatrics | 8733 Beverly Blvd, Suite 200, West Hollywood, CA 90048-1827 | 2012-02-28 |
| 1346510245 | Neufeld Medical Group | Pediatrics | 8733 Beverly Blvd, Suite 202, West Hollywood, CA 90048-1827 | 2012-01-09 |
| 1851684336 | Jeffrey Nathan Grant,m.d. A Medical Corp | Clinic/Center | 8733 Beverly Blvd, West Hollywood, CA 90048-1827 | 2011-05-17 |
| 1770872558 | Perry Alan Meier | Radiologic Technologist | 8733 Beverly Blvd, Suite 306, West Hollywood, CA 90048-1843 | 2011-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1760090062 | New Dawn Tms Psychiatry | Clinic/Center | 640 S San Vincente Blvd, Ste. 210, Los Angeles, CA 90048 | 2020-07-22 |
| 1114547312 | Savannah Marie Gonzales | Student in an Organized Health Care Education/Training Program | 8700 Beverly Blvd Suite 3636, Los Angeles, CA 90048 | 2020-04-17 |
| 1861048613 | Sam Dawkins | Internal Medicine | Suite 415e, 8631 West Third Street, Los Angeles, CA 90048 | 2019-08-16 |
| 1295202638 | Caleb Rogers Penn | Anesthesiology | Cedars-sinai Department of Anesthesiology, 8700 Beverly Blvd, Los Angeles, CA 90048 | 2018-10-24 |
| 1437641727 | Medical Imaging Center of Southern California-beverly Hills, Inc | Radiology | 8727 Beverly Blvd, Los Angeles, CA 90048 | 2018-06-01 |
| 1689164121 | Maulin Shah | Student in an Organized Health Care Education/Training Program | 8700 Beverly Blvd Suite 5512, Los Angeles, CA 90048 | 2018-05-10 |
| 1013423631 | Abdul Ali Qaderi | Anesthesiology | 8700 Beverly Blvd Suite 4209, Los Angeles, CA 90048 | 2017-12-19 |
| 1619483559 | Sakeenah Hakim | Social Worker | 292 S. La Cienega Blvd, Suite 102, Los Angeles, CA 90048 | 2017-12-14 |
| 1851805048 | West Hollywood Medical Group Inc | General Practice | 8733 Beverly Blvd Suite #203, West Hollywood, CA 90048 | 2017-11-27 |
| Find all providers in zip 90048 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477054567 | Innova Rx Inc. | Pharmacy | 8737 Beverly Blvd Ste 102, West Hollywood, CA 90048-1835 | 2018-02-23 |
| 1952317273 | Vls Capitol Drugs Inc | Pharmacy | 8578 Santa Monica Blvd, West Hollywood, CA 90069-4119 | 2006-07-31 |
| 1285649814 | Fred P Startz | Pharmacy | 8933 Santa Monica Blvd, West Hollywood, CA 90069-4912 | 2006-07-30 |
| 1053353243 | Garfield Beach Cvs LLC | Pharmacy | 8491 Santa Monica Blvd, West Hollywood, CA 90069-4218 | 2006-06-12 |
| 1538363585 | Ralphs Grocery Company | Pharmacy | 7257 W Sunset Blvd, West Hollywood, CA 90046-3409 | 2007-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689987 | Capsule San Diego LLC | Pharmacy | 1450 Columbia St Ste B, San Diego, CA 92101-3487 | 2020-11-04 |
| 1023618824 | Ingram's Pharmacy, LLC | Pharmacy | 1115 Union Ave Unit 147-1c, Bakersfield, CA 93307-1050 | 2020-10-29 |
| 1750981874 | Capsule San Francisco LLC | Pharmacy | 475 University Ave, Palo Alto, CA 94301-1814 | 2020-10-28 |
| 1447850623 | Sterling Hatteras LLC | Pharmacy | 916 E Cypress Ave Ste 300, Redding, CA 96002-1038 | 2020-10-28 |
| 1922608454 | Vanessa Ann Marie Rita Pitts | Pharmacy | 26365 Buccaneer Ln, Helendale, CA 92342-7739 | 2020-10-26 |
| 1205435971 | Rinaldi Pharmacy, Inc. | Pharmacy | 11237 Tampa Ave, Porter Ranch, CA 91326-1610 | 2020-10-22 |
| 1467051300 | San Dimas Wellness Pharmacy | Pharmacy | 830 W Arrow Hwy Ste 830b, San Dimas, CA 91773-2498 | 2020-10-21 |
| 1225636889 | Med-plus Pharmacy Inc | Pharmacy | 335 Lindbergh Ave, Livermore, CA 94551-9291 | 2020-10-15 |
| 1689271066 | Innova Pharmacy Iv | Pharmacy | 4815 Watt Ave Ste B101, North Highlands, CA 95660-5108 | 2020-10-08 |
| 1114524683 | Bear Valley Pharmacy | Pharmacy | 17003 Bear Valley Rd Ste B, Hesperia, CA 92345-1420 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
| City | WEST HOLLYWOOD |
| Zip Code | 90048 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.