Provider Demographics
NPI:1891416566
Name:BANSIL, CLAIRE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:
Last Name:BANSIL
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 1:17790 KIOWA TRL
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95033-8880
Mailing Address - Country:US
Mailing Address - Phone:530-277-6188
Mailing Address - Fax:
Practice Address - Street 1:210 MOUNT HERMON RD
Practice Address - Street 2:
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95066-4009
Practice Address - Country:US
Practice Address - Phone:831-430-9113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA70055OtherCALIFORNIA STATE BOARD OF PHARMACY - PHARMACIST LICENSE