Provider Demographics
NPI:1942529771
Name:STEIN, SHELDON MARSHALL (RPH)
Entity Type:Individual
Prefix:MR
First Name:SHELDON
Middle Name:MARSHALL
Last Name:STEIN
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 1:14451 WILDEVE LN
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-5724
Mailing Address - Country:US
Mailing Address - Phone:714-731-6625
Mailing Address - Fax:714-731-6625
Practice Address - Street 1:1406 W EDINGER AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-4307
Practice Address - Country:US
Practice Address - Phone:714-546-6191
Practice Address - Fax:714-546-5037
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23776183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist