Provider Demographics
NPI:1013472562
Name:CHOLLERA, HEENA R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HEENA
Middle Name:R
Last Name:CHOLLERA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 E COMMONWEALTH AVE APT F
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-6194
Mailing Address - Country:US
Mailing Address - Phone:909-802-0978
Mailing Address - Fax:
Practice Address - Street 1:209 E COMMONWEALTH AVE APT F
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-6194
Practice Address - Country:US
Practice Address - Phone:909-802-0978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77264183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist