Provider Demographics
NPI:1053626457
Name:SHAH, UMANG NATVARLAL (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:DR
First Name:UMANG
Middle Name:NATVARLAL
Last Name:SHAH
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:510 E 3RD ST APT 209
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-1942
Mailing Address - Country:US
Mailing Address - Phone:213-255-1370
Mailing Address - Fax:909-793-5492
Practice Address - Street 1:700 E REDLANDS BLVD STE A
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-6168
Practice Address - Country:US
Practice Address - Phone:909-793-3568
Practice Address - Fax:909-793-5492
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist