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General NPI Number Information
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NPI Number | 1568806099
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Entity Type | Individual
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Provider Name | ORLY SHAKKED RPH
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Gender | Female
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 04/26/2013
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Provider Practice Location Address
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Address Line | 1385 TAVERN RD
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City | ALPINE
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State | CA
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Zip | 91901-3833
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Country | US
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Telephone | 619-445-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 12483 CARMEL POINTE
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City | SAN DIEGO
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State | CA
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Zip | 92130-2269
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Country | US
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Telephone | 858-847-9670
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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 | 58271
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License Number State | CA
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