Provider Demographics
NPI:1154581916
Name:CHERUKURI, SATYANARAYANA (PHARMACIST)
Entity type:Individual
Prefix:
First Name:SATYANARAYANA
Middle Name:
Last Name:CHERUKURI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-2400
Mailing Address - Country:US
Mailing Address - Phone:925-757-7161
Mailing Address - Fax:
Practice Address - Street 1:20 E 18TH ST
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-2400
Practice Address - Country:US
Practice Address - Phone:925-757-7161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58362183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist