1760763627 NPI number — MS. TIFFANI CONSTANTINO AL-SHAIKH PHARMD

Table of content: MS. TIFFANI CONSTANTINO AL-SHAIKH PHARMD (NPI 1760763627)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760763627 NPI number — MS. TIFFANI CONSTANTINO AL-SHAIKH PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AL-SHAIKH
Provider First Name:
TIFFANI
Provider Middle Name:
CONSTANTINO
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760763627
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10556 COMBIE RD
Provider Second Line Business Mailing Address:
PMB 6618
Provider Business Mailing Address City Name:
AUBURN
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95602-8908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-644-8938
Provider Business Mailing Address Fax Number:
530-268-2355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10556 COMBIE RD
Provider Second Line Business Practice Location Address:
PMB 6618
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95602-8908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-644-8938
Provider Business Practice Location Address Fax Number:
530-268-2355
Provider Enumeration Date:
09/06/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  51103 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com