Healthcare Provider Details

I. General information

NPI: 1255631305
Provider Name (Legal Business Name): ALI SHAFIEE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2010
Last Update Date: 10/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 MID VALLEY CTR
CARMEL CA
93923-8500
US

IV. Provider business mailing address

104 MID VALLEY CTR
CARMEL CA
93923-8500
US

V. Phone/Fax

Practice location:
  • Phone: 831-624-1620
  • Fax: 831-624-1838
Mailing address:
  • Phone: 831-624-1620
  • Fax: 831-624-1838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number35277
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: