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General NPI Number Information
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NPI Number | 1891214219
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Entity Type | Individual
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Provider Name | JONATHAN CHHEUY
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Gender | Male
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Dates
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Enumeration Date | 09/18/2017
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Last Update Date | 12/18/2019
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Provider Practice Location Address
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Address Line | 23801 WASHINGTON AVE
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City | MURRIETA
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State | CA
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Zip | 92562-2264
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Country | US
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Telephone | 951-600-8639
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Fax |
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Provider Business Mailing Address
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Address Line | 4330 DRIVING RANGE RD
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City | CORONA
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State | CA
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Zip | 92883-0688
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 77007
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License Number State | CA
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