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General NPI Number Information
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NPI Number | 1831343532
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Entity Type | Individual
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Provider Name | JWALANT SHUKLA RPH
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Gender | Male
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 10/15/2010
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Provider Practice Location Address
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Address Line | 707 CONTINENTAL CIR # 1437
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-3366
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Country | US
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Telephone | 650-966-1910
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Fax |
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Provider Business Mailing Address
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Address Line | 210 VISTA COVE CIR
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City | SACRAMENTO
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State | CA
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Zip | 95835-2002
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Country | US
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Telephone | 916-285-0470
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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 | 55609
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License Number State | CA
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