MEDICARE: SHIMONA BREZIL MENEZES

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	83518	CA

General Provider Information

NPI Number	:	1457943219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIMONA BREZIL MENEZES

Provider Business Mailing Address
First Line	:	1930 N PLACENTIA AVE # 819
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92831-1522
Country	:	US
Telephone Number	:	714-792-0990
Fax Number	:

Provider Business Practice Location Address
First Line	:	1930 N PLACENTIA AVE # 819
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92831-1522
Country	:	US
Telephone Number	:	714-792-0990
Fax Number	:

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

Provider Enumeration Date	:	02/03/2021
Last Update Date	:	02/03/2021

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Directions to “ SHIMONA BREZIL MENEZES ” Practice Location

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