Provider Demographics
NPI:1740555473
Name:SHIH, ERNEST (BS)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:
Last Name:SHIH
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 DEININGER CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92880-1707
Mailing Address - Country:US
Mailing Address - Phone:951-493-2371
Mailing Address - Fax:888-545-4615
Practice Address - Street 1:215 DEININGER CIR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880-1707
Practice Address - Country:US
Practice Address - Phone:951-493-2371
Practice Address - Fax:888-545-4615
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36165183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH36165OtherCALIFORNIA STATE BOARD OF PHARMACY