Provider Demographics
NPI:1790150944
Name:KUMAR, SHELLY MCFADDEN (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:MCFADDEN
Last Name:KUMAR
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 1:2501 VIA RIVERA
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-2729
Mailing Address - Country:US
Mailing Address - Phone:310-544-0337
Mailing Address - Fax:
Practice Address - Street 1:2501 VIA RIVERA
Practice Address - Street 2:
Practice Address - City:PALOS VERDES ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-2729
Practice Address - Country:US
Practice Address - Phone:310-544-0337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA448301835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care