MEDICARE: SHARON MAY SIU

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	61245	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	61245	OTHER	CA	CALIFORNIA BOARD OF PHARMACY

General Provider Information

NPI Number	:	1245755685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON MAY SIU

Provider Business Mailing Address
First Line	:	16286 LONE BLUFF CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92127-3478
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10575 SCRIPPS POWAY PKWY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92131-3917
Country	:	US
Telephone Number	:	858-547-3936
Fax Number	:

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

Provider Enumeration Date	:	08/07/2017
Last Update Date	:	08/07/2017

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Directions to “ SHARON MAY SIU ” Practice Location

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