Provider Demographics
NPI:1194897520
Name:UCI STUDENT HEALTH CENTER PHARMACY
Entity type:Organization
Organization Name:UCI STUDENT HEALTH CENTER PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:SHIOYA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:949-824-2643
Mailing Address - Street 1:501 STUDENT HEALTH CENTER DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92697-5200
Mailing Address - Country:US
Mailing Address - Phone:949-824-1440
Mailing Address - Fax:949-824-3666
Practice Address - Street 1:501 STUDENT HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92697-5200
Practice Address - Country:US
Practice Address - Phone:949-824-1440
Practice Address - Fax:949-824-3666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHE35938183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty