MEDICARE: DR. SHAWN KEIKO KANEHIRA-MAR PHARM.D.

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	2226	HI
2	183500000X	Pharmacist	51991	CA

General Provider Information

NPI Number	:	1902918295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAWN KEIKO KANEHIRA-MAR PHARM.D.

Provider Business Mailing Address
First Line	:	1 QUALITY DR
Second Line	:
City	:	VACAVILLE
State	:	CA
Zip	:	95688-9494
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 QUALITY DR
Second Line	:
City	:	VACAVILLE
State	:	CA
Zip	:	95688-9494
Country	:	US
Telephone Number	:	707-624-2013
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	12/03/2021

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