Provider Demographics
NPI:1235824012
Name:THIARA, NOVELEEN SINGH (PHARMD)
Entity Type:Individual
Prefix:
First Name:NOVELEEN
Middle Name:SINGH
Last Name:THIARA
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:PO BOX 646
Mailing Address - Street 2:
Mailing Address - City:FRENCH CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:95231-0646
Mailing Address - Country:US
Mailing Address - Phone:209-483-3926
Mailing Address - Fax:
Practice Address - Street 1:1801 COLORADO AVE STE 300
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2708
Practice Address - Country:US
Practice Address - Phone:209-850-8818
Practice Address - Fax:209-850-8828
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist