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General NPI Number Information
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NPI Number | 1801196985
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Entity Type | Individual
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Provider Name | KAM SHOATNANON
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Gender | Male
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Dates
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Enumeration Date | 10/23/2010
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Last Update Date | 10/23/2010
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Provider Practice Location Address
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Address Line | 40044 HIGHWAY 49 STE D
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City | OAKHURST
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State | CA
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Zip | 93644-8875
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Country | US
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Telephone | 559-642-4255
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Fax |
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Provider Business Mailing Address
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Address Line | 4974 N FRESNO ST # 291
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City | FRESNO
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State | CA
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Zip | 93726-0317
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Country | US
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Telephone |
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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 | 41134
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License Number State | CA
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