Provider Demographics
NPI:1467603381
Name:STRASSER, SHAYNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHAYNE
Middle Name:
Last Name:STRASSER
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 1:1449 E F ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361-9265
Mailing Address - Country:US
Mailing Address - Phone:209-847-4279
Mailing Address - Fax:209-848-3210
Practice Address - Street 1:1449 E F ST
Practice Address - Street 2:SUITE 102
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-9265
Practice Address - Country:US
Practice Address - Phone:209-847-4279
Practice Address - Fax:209-848-3210
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42884183500000X
NV10189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist