Provider Demographics
NPI:1306099627
Name:ENO, CHADD (PHARMD)
Entity type:Individual
Prefix:
First Name:CHADD
Middle Name:
Last Name:ENO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 LILY WAY
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-7378
Mailing Address - Country:US
Mailing Address - Phone:760-716-2555
Mailing Address - Fax:
Practice Address - Street 1:4 LILY WAY
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-7378
Practice Address - Country:US
Practice Address - Phone:760-716-2555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist