Provider Demographics
NPI:1154855294
Name:SHAHDAWALA, ABDOALI (PHARMD)
Entity Type:Individual
Prefix:
First Name:ABDOALI
Middle Name:
Last Name:SHAHDAWALA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1839A YGNACIO VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3214
Mailing Address - Country:US
Mailing Address - Phone:925-954-7869
Mailing Address - Fax:925-954-7925
Practice Address - Street 1:1839A YGNACIO VALLEY RD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3214
Practice Address - Country:US
Practice Address - Phone:925-954-7869
Practice Address - Fax:925-954-7925
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-15
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist