Provider Demographics
NPI:1104652148
Name:DARCHINI ASTANEH, SHAMIM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHAMIM
Middle Name:
Last Name:DARCHINI ASTANEH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20100 SPECTRUM
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3415
Mailing Address - Country:US
Mailing Address - Phone:424-216-0110
Mailing Address - Fax:
Practice Address - Street 1:8950 VILLA LA JOLLA DR STE C225
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1713
Practice Address - Country:US
Practice Address - Phone:619-270-8688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89021183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist