Provider Demographics
NPI:1497807945
Name:JEFFREY K. SHINODA, PHARM.D., INC.
Entity Type:Organization
Organization Name:JEFFREY K. SHINODA, PHARM.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHINODA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:559-435-2425
Mailing Address - Street 1:6121 N THESTA ST STE 204
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5294
Mailing Address - Country:US
Mailing Address - Phone:559-435-2425
Mailing Address - Fax:559-438-4372
Practice Address - Street 1:6121 N THESTA ST
Practice Address - Street 2:STE 204
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5294
Practice Address - Country:US
Practice Address - Phone:559-435-2425
Practice Address - Fax:559-438-4372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH418521835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835X0200XPharmacy Service ProvidersPharmacistOncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY47019OtherPHARMACY
5615123OtherNABP
CALSC99279OtherSTERILE CLEAN ROOM
CALSC99279OtherSTERILE CLEAN ROOM
CAPHY47019OtherPHARMACY