Provider Demographics
NPI:1760049597
Name:SHANBHAG, ANANT (RPH)
Entity Type:Individual
Prefix:MR
First Name:ANANT
Middle Name:
Last Name:SHANBHAG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041-1270
Mailing Address - Country:US
Mailing Address - Phone:650-691-4004
Mailing Address - Fax:
Practice Address - Street 1:850 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94041-1270
Practice Address - Country:US
Practice Address - Phone:650-691-4004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59430183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist