MEDICARE: SHUO GAO

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	19058	NV

General Provider Information

NPI Number	:	1881290021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHUO GAO

Provider Business Mailing Address
First Line	:	170 LEMMON DR
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89506-8799
Country	:	US
Telephone Number	:	775-677-4884
Fax Number	:

Provider Business Practice Location Address
First Line	:	170 LEMMON DR
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89506-8799
Country	:	US
Telephone Number	:	775-677-4884
Fax Number	:

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

Provider Enumeration Date	:	12/10/2020
Last Update Date	:	12/10/2020

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Directions to “ SHUO GAO ” Practice Location

Language	Start Address	Practice Location

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