Provider Demographics
NPI:1992018246
Name:SENEMAR, ELHAM (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:ELHAM
Middle Name:
Last Name:SENEMAR
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4515 KINGSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-6034
Mailing Address - Country:US
Mailing Address - Phone:925-648-9193
Mailing Address - Fax:925-648-9295
Practice Address - Street 1:1997 TICE VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595-2201
Practice Address - Country:US
Practice Address - Phone:925-932-0568
Practice Address - Fax:925-932-0335
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist