Provider Demographics
NPI:1972163442
Name:CLAIRE, SANDEEP KAUR (PHARM D)
Entity type:Individual
Prefix:
First Name:SANDEEP
Middle Name:KAUR
Last Name:CLAIRE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15933 PEACH AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:CA
Mailing Address - Zip Code:95334-9540
Mailing Address - Country:US
Mailing Address - Phone:209-585-7896
Mailing Address - Fax:
Practice Address - Street 1:1701 BELLEVUE RD
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-2604
Practice Address - Country:US
Practice Address - Phone:209-357-2956
Practice Address - Fax:209-357-8172
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60694183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist