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General NPI Number Information
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NPI Number | 1457815508
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Entity Type | Individual
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Provider Name | NIEN SHAAW
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Gender | Female
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Dates
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Enumeration Date | 01/23/2019
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 101 REDLANDS MALL CVS PHARMACY
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City | REDLANDS
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State | CA
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Zip | 92373
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Country | US
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Telephone | 909-792-9684
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 434
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City | WEST COVINA
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State | CA
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Zip | 91793-0434
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Country | US
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Telephone | 909-792-9688
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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 | 55744
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License Number State | CA
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