Individual
DR. SUSHMA RAO SHIRAVANTHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, PHARMD, BCPS
Contact information
Practice address
3801 MIRANDA AVE, PALO ALTO, CA 94304-1207
(650) 493-5000
Mailing address
521 ASPEN PL, EAST PALO ALTO, CA 94303-1348
(248) 767-4249
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
26026674A
IN
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
26026674A
IN
1835P1200X
Pharmacotherapy Pharmacist
Primary
26026674A
IN
Other
Enumeration date
02/22/2019
Last updated
02/22/2019
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