Provider Demographics
NPI:1164897609
Name:SHETH, JAMI SHAH (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:SHAH
Last Name:SHETH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1534 15TH ST APT 7
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-3322
Mailing Address - Country:US
Mailing Address - Phone:302-753-4890
Mailing Address - Fax:
Practice Address - Street 1:15150 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3720
Practice Address - Country:US
Practice Address - Phone:310-454-1345
Practice Address - Fax:310-573-0016
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68709183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist