Provider Demographics
NPI:1750059846
Name:SALIB, SHEREHAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHEREHAN
Middle Name:
Last Name:SALIB
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 1:2 VENTANA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1849
Mailing Address - Country:US
Mailing Address - Phone:914-356-3128
Mailing Address - Fax:
Practice Address - Street 1:17332 VON KARMAN AVE STE 110
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6280
Practice Address - Country:US
Practice Address - Phone:949-393-5780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65914183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist