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NPI 1922411826

NPI 1922411826 : DR. ASHOK KUMAR PUNATI : LODI, CA

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General NPI Number Information
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    NPI Number           |    1922411826
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    Entity Type          |    Individual 
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    Provider Name        |    DR. ASHOK KUMAR PUNATI
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/09/2014
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    Last Update Date     |    06/09/2014
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Provider Practice Location Address
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    Address Line         |    520 W LODI 
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    City                 |    LODI
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    State                |    CA
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    Zip                  |    94568
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    Country              |    US
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    Telephone            |    209-368-5363
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    Fax                  |    209-368-2702
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Provider Business Mailing Address
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    Address Line         |    520 W LODI AVE 
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    City                 |    LODI
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    State                |    CA
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    Zip                  |    95240-3425
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    Country              |    US
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    Telephone            |    209-368-5363
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    Fax                  |    209-368-2702
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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       |    65745
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    License Number State |    CA
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