MEDICARE: NOVELEEN SINGH THIARA 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
1	183500000X	Pharmacist	87739	CA

General Provider Information

NPI Number	:	1235824012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOVELEEN SINGH THIARA PHARMD

Provider Business Mailing Address
First Line	:	PO BOX 646
Second Line	:
City	:	FRENCH CAMP
State	:	CA
Zip	:	95231-0646
Country	:	US
Telephone Number	:	209-483-3926
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 COLORADO AVE STE 300
Second Line	:
City	:	TURLOCK
State	:	CA
Zip	:	95382-2708
Country	:	US
Telephone Number	:	209-850-8818
Fax Number	:	209-850-8828

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2023
Last Update Date	:	04/07/2023

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