Provider Demographics
NPI:1093999286
Name:BONNET, SHARI BETH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:BETH
Last Name:BONNET
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3161 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-2354
Mailing Address - Country:US
Mailing Address - Phone:714-434-6174
Mailing Address - Fax:
Practice Address - Street 1:1140 WEST LAVETA AVENUE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-744-8724
Practice Address - Fax:714-744-8676
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46951183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist