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General NPI Number Information
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NPI Number | 1104314749
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Entity Type | Individual
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Provider Name | VIRAL SHAH B.PHARM
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Gender | Female
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 4210 HIGHLAND AVE # K
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City | HIGHLAND
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State | CA
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Zip | 92346-2742
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Country | US
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Telephone | 909-425-8687
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Fax |
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Provider Business Mailing Address
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Address Line | 1567 CRESTVIEW RD
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City | REDLANDS
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State | CA
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Zip | 92374-6378
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Country | US
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Telephone | 714-262-1115
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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 | 55514
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License Number State | CA
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