Provider Demographics
NPI:1255631305
Name:SHAFIEE, ALI (RPH)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:SHAFIEE
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 1:104 MID VALLEY CTR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8500
Mailing Address - Country:US
Mailing Address - Phone:831-624-1620
Mailing Address - Fax:831-624-1838
Practice Address - Street 1:104 MID VALLEY CTR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8500
Practice Address - Country:US
Practice Address - Phone:831-624-1620
Practice Address - Fax:831-624-1838
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35277183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist