OrganizationActive
Peticub
NPI 1790049484 · Community/Retail Pharmacy · Los Angeles, CA
Provider details
- NPI number
- 1790049484
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Rabin Shaoulian, Location Manager(310) 839-7387
Specialties & taxonomies
Suppliers
- Mail Order Pharmacy3336M0002X
Suppliers
- Home Infusion Therapy Pharmacy3336H0001X
Suppliers
- Compounding Pharmacy3336C0004X
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1804 S La Cienega Blvd # 102
Los Angeles, CA 90035-4670
Phone: (310) 839-7387
Fax: (310) 288-9141
Street-level locationGet directions
Mailing address
1804 S La Cienega Blvd # 102
Los Angeles, CA 90035-4670
Other names (DBA / former)
- Doing business as
- Peticub
Registry dates
- Enumerated
- 2012-06-27
- Last updated
- 2012-08-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.