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General NPI Number Information
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NPI Number | 1205408689
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Entity Type | Individual
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Provider Name | NANJOO SHIN PHARM D
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Gender | Female
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Dates
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Enumeration Date | 07/14/2021
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 740 W ALLUVIAL AVE STE 101
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City | FRESNO
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State | CA
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Zip | 93711-5509
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Country | US
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Telephone | 800-797-3543
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Fax |
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Provider Business Mailing Address
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Address Line | 1345 EMERALD DR APT 214
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City | LOS ANGELES
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State | CA
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Zip | 90026-2138
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Country | US
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Telephone | 213-999-8814
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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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 84251
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 60126
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 84251
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License Number State | CA
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