Provider Demographics
NPI:1275330375
Name:CHIVUKULA, PAD (PHD)
Entity type:Individual
Prefix:DR
First Name:PAD
Middle Name:
Last Name:CHIVUKULA
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10285 SCIENCE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1117
Mailing Address - Country:US
Mailing Address - Phone:858-900-2662
Mailing Address - Fax:
Practice Address - Street 1:10285 SCIENCE CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1117
Practice Address - Country:US
Practice Address - Phone:858-900-2662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist