Provider Demographics
NPI:1891392874
Name:ALRAWI, SHAMS
Entity Type:Individual
Prefix:
First Name:SHAMS
Middle Name:
Last Name:ALRAWI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 CREEKSIDE DR APT 142
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-7408
Mailing Address - Country:US
Mailing Address - Phone:925-567-4570
Mailing Address - Fax:
Practice Address - Street 1:243 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-1898
Practice Address - Country:US
Practice Address - Phone:510-783-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-03
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist