MEDICARE: DR. ALLEN SHEK PHARM.D., BCPS

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	1835P1200X	Pharmacotherapy Pharmacist	RPH44887	CA
2	1835P1200X	Pharmacotherapy Pharmacist		IL

General Provider Information

NPI Number	:	1285631556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLEN SHEK PHARM.D., BCPS

Provider Business Mailing Address
First Line	:	TJL SCHOOL OF PHARMACY, 3601 PACIFIC AVE
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95211-0001
Country	:	US
Telephone Number	:	209-482-2670
Fax Number	:	209-461-2409

Provider Business Practice Location Address
First Line	:	500 WEST HOSPITAL RD
Second Line	:	SAN JOAQUIN GENERAL HOSPITAL, OUTPATIENT PHARMACY
City	:	FRENCH CAMP
State	:	CA
Zip	:	95231
Country	:	US
Telephone Number	:	209-482-2670
Fax Number	:	209-461-2409

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	07/08/2007

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