Healthcare Provider Details

I. General information

NPI: 1497807945
Provider Name (Legal Business Name): JEFFREY K. SHINODA, PHARM.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6121 N THESTA ST STE 204
FRESNO CA
93710-5294
US

IV. Provider business mailing address

6121 N THESTA ST STE 204
FRESNO CA
93710-5294
US

V. Phone/Fax

Practice location:
  • Phone: 559-435-2425
  • Fax: 559-438-4372
Mailing address:
  • Phone: 559-435-2425
  • Fax: 559-438-4372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberRPH41852
License Number StateCA

VIII. Authorized Official

Name: DR. JEFF K SHINODA
Title or Position: PRESIDENT
Credential: PHARM.D.
Phone: 559-435-2425