Provider Demographics
NPI:1881281772
Name:SWAROOP, SHAILESH
Entity type:Individual
Prefix:DR
First Name:SHAILESH
Middle Name:
Last Name:SWAROOP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 GEODE LN
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-1736
Mailing Address - Country:US
Mailing Address - Phone:760-402-9854
Mailing Address - Fax:
Practice Address - Street 1:1800 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-7700
Practice Address - Country:US
Practice Address - Phone:760-945-2091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-25
Last Update Date:2020-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45718183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist