MEDICARE: SHARONLEE KOTABE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH 24534	CA

General Provider Information

NPI Number	:	1427135870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARONLEE KOTABE PHARMD

Provider Business Mailing Address
First Line	:	395 HAMILTON ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94134-1437
Country	:	US
Telephone Number	:	415-656-1532
Fax Number	:

Provider Business Practice Location Address
First Line	:	2789 25TH ST
Second Line	:	ROOM 2010
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-3516
Country	:	US
Telephone Number	:	415-206-2325
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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