Provider Demographics
NPI:1023900131
Name:BATH, SHAMEEM AKHTAR
Entity type:Individual
Prefix:
First Name:SHAMEEM
Middle Name:AKHTAR
Last Name:BATH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 VISTA COVE CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-2002
Mailing Address - Country:US
Mailing Address - Phone:530-788-4708
Mailing Address - Fax:
Practice Address - Street 1:1000 SUTTER ST
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3504
Practice Address - Country:US
Practice Address - Phone:530-673-9420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90878183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist