Provider Demographics
NPI:1619006095
Name:HARA, SHIRLEY MACHIKO (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:MACHIKO
Last Name:HARA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MISS
Other - First Name:SHIRLEY
Other - Middle Name:MACHIKO
Other - Last Name:TAKIGAWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:25825 VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-3518
Mailing Address - Country:US
Mailing Address - Phone:310-517-2239
Mailing Address - Fax:
Practice Address - Street 1:25825 VERMONT AVE
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-3518
Practice Address - Country:US
Practice Address - Phone:310-517-2239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37896183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist