Provider Demographics
NPI:1487109310
Name:SHIMPI, RESHMA AJIT (R PH)
Entity type:Individual
Prefix:
First Name:RESHMA
Middle Name:AJIT
Last Name:SHIMPI
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:RESHMA
Other - Middle Name:DATTATRAYA
Other - Last Name:DATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BPHARM,M PHARMSCI
Mailing Address - Street 1:7173 BRISBANE CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-4649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39400 PASEO PADRE PKWY
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2310
Practice Address - Country:US
Practice Address - Phone:510-248-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-21
Last Update Date:2016-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH62687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist