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General NPI Number Information
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NPI Number | 1972976728
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Entity Type | Individual
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Provider Name | SHON GULATI
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Gender | Male
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Dates
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Enumeration Date | 11/02/2015
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Last Update Date | 11/02/2015
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Provider Practice Location Address
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Address Line | 3016 KENNEDY ST
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City | LIVERMORE
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State | CA
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Zip | 94551-5928
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Country | US
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Telephone | 925-209-1658
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Fax |
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Provider Business Mailing Address
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Address Line | 3016 KENNEDY ST
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City | LIVERMORE
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State | CA
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Zip | 94551-5928
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Country | US
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Telephone | 925-209-1658
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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 | 72430
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License Number State | CA
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