Healthcare Provider Details

I. General information

NPI: 1023266731
Provider Name (Legal Business Name): SHELLEY LEW PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2008
Last Update Date: 09/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W SHAW AVE STE 114
CLOVIS CA
93612-3680
US

IV. Provider business mailing address

300 W SHAW AVE STE 114
CLOVIS CA
93612-3680
US

V. Phone/Fax

Practice location:
  • Phone: 559-297-0251
  • Fax: 559-297-4251
Mailing address:
  • Phone: 559-297-0251
  • Fax: 559-297-4251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH47197
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: