Healthcare Provider Details

I. General information

NPI: 1760601645
Provider Name (Legal Business Name): RESHMA SHROFF RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11172 LOS ALAMITOS BLVD
LOS ALAMITOS CA
90720-3621
US

IV. Provider business mailing address

3452 ROSSMOOR WAY
ROSSMOOR CA
90720-4347
US

V. Phone/Fax

Practice location:
  • Phone: 562-430-3323
  • Fax: 562-431-5863
Mailing address:
  • Phone: 562-493-0175
  • Fax: 562-431-5863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number45223
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: