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NPI Code Detail

MEDICARE: RAVI YATIN SHAH PHARMD

MEDICARE: RAVI YATIN SHAH PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist78269CA

General Provider Information

NPI Number : 1053812263
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAVI YATIN SHAH PHARMD
Provider Business Mailing Address
First Line : 10420 SILTSTONE WAY
Second Line :
City : ELK GROVE
State : CA
Zip : 95757-1669
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2703 ORO DAM BLVD E
Second Line :
City : OROVILLE
State : CA
Zip : 95966-5116
Country : US
Telephone Number : 530-534-1283
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2018
Last Update Date : 12/22/2022

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Directions to “ RAVI YATIN SHAH PHARMD” Practice Location

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