Healthcare Provider Details

I. General information

NPI: 1760159610
Provider Name (Legal Business Name): SHAFAGH ESLAMI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2021
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10685 MERRITT ST
CASTROVILLE CA
95012-3312
US

IV. Provider business mailing address

10685 MERRITT ST
CASTROVILLE CA
95012-3312
US

V. Phone/Fax

Practice location:
  • Phone: 831-632-5011
  • Fax: 408-850-5784
Mailing address:
  • Phone: 831-632-5011
  • Fax: 408-850-5784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH84871
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: