Provider Demographics
NPI:1700152683
Name:DO, SHIRLEY (RPH)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:DO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-4302
Mailing Address - Country:US
Mailing Address - Phone:408-228-2144
Mailing Address - Fax:
Practice Address - Street 1:1101 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-4302
Practice Address - Country:US
Practice Address - Phone:408-228-2144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH57495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist