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General NPI Number Information
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NPI Number | 1063281913
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Entity Type | Individual
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Provider Name | SHAPATUR NUR BADHON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 2623 E SLAUSON AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-2926
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Country | US
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Telephone | 323-583-1931
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Fax |
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Provider Business Mailing Address
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Address Line | 9750 WASHINGTON BLVD
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City | PICO RIVERA
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State | CA
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Zip | 90660-3952
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Country | US
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Telephone | 213-327-8498
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH88497
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License Number State | CA
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