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NPI Code Detail

MEDICARE: ETWINA SHARON PAU CPHT

MEDICARE: ETWINA SHARON PAU CPHT
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
1183700000XPharmacy Technician8440CA

General Provider Information

NPI Number : 1437784436
Entity Type Code : Individual
Provider Name (Legal Business Name) : ETWINA SHARON PAU CPHT
Provider Business Mailing Address
First Line : 2313 SILK CT
Second Line :
City : FAIRFIELD
State : CA
Zip : 94534-1780
Country : US
Telephone Number : 401-479-6511
Fax Number :
Provider Business Practice Location Address
First Line : 300 TRAVIS BLVD
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-3804
Country : US
Telephone Number : 401-479-6511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2020
Last Update Date : 11/27/2023

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Directions to “ ETWINA SHARON PAU CPHT” Practice Location

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