Provider Demographics
NPI:1548912215
Name:SHAHNOOSHI, DAVID H (PHARMD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:H
Last Name:SHAHNOOSHI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3690 S PARK AVE STE 805
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-5042
Mailing Address - Country:US
Mailing Address - Phone:970-433-1629
Mailing Address - Fax:
Practice Address - Street 1:3690 S PARK AVE STE 805
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-5042
Practice Address - Country:US
Practice Address - Phone:520-616-6760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist