Provider Demographics
NPI:1902960776
Name:SHINOHARA, YASUO TODD (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:YASUO
Middle Name:TODD
Last Name:SHINOHARA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:MR
Other - First Name:TODD
Other - Middle Name:
Other - Last Name:SHINOHARA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1420 N. TRACY BLVD
Mailing Address - Street 2:SUTTER TRACY COMMUNITY HOSPITAL
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-3497
Mailing Address - Country:US
Mailing Address - Phone:209-833-2456
Mailing Address - Fax:209-832-6510
Practice Address - Street 1:1420 N. TRACY BLVD
Practice Address - Street 2:SUTTER TRACY COMMUNITY HOSPITAL
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3497
Practice Address - Country:US
Practice Address - Phone:209-833-2456
Practice Address - Fax:209-832-6510
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45774183500000X
CO13591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist