Provider Demographics
NPI:1386494292
Name:CHODAY, KIRTHI (PHARMD)
Entity type:Individual
Prefix:
First Name:KIRTHI
Middle Name:
Last Name:CHODAY
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 1:11195 LEE WAY APT 34501
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-6741
Mailing Address - Country:US
Mailing Address - Phone:408-858-5147
Mailing Address - Fax:
Practice Address - Street 1:6725 MESA RIDGE RD STE 230
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2925
Practice Address - Country:US
Practice Address - Phone:858-275-2144
Practice Address - Fax:858-281-0045
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH793021835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist