Provider Demographics
NPI:1063076172
Name:CHEN, SHU HAN (RPH)
Entity type:Individual
Prefix:
First Name:SHU HAN
Middle Name:
Last Name:CHEN
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 1:12113 SARATOGA VILLA PL
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-3023
Mailing Address - Country:US
Mailing Address - Phone:408-644-8923
Mailing Address - Fax:
Practice Address - Street 1:3081 STEVENS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-6704
Practice Address - Country:US
Practice Address - Phone:408-241-5141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA509411835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty