MEDICARE: KIRTHI CHODAY PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RPH79302	CA

General Provider Information

NPI Number	:	1386494292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRTHI CHODAY PHARMD

Provider Business Mailing Address
First Line	:	11195 LEE WAY APT 34501
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-6741
Country	:	US
Telephone Number	:	408-858-5147
Fax Number	:

Provider Business Practice Location Address
First Line	:	6725 MESA RIDGE RD STE 230
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-2925
Country	:	US
Telephone Number	:	858-275-2144
Fax Number	:	858-281-0045

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2024
Last Update Date	:	03/25/2024

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Directions to “ KIRTHI CHODAY PHARMD” Practice Location

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