Provider Demographics
NPI:1427502970
Name:DURU, CHUMA C JR (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CHUMA
Middle Name:C
Last Name:DURU
Suffix:JR
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9805 JAKE LN
Mailing Address - Street 2:#14202
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-2994
Mailing Address - Country:US
Mailing Address - Phone:972-900-6539
Mailing Address - Fax:
Practice Address - Street 1:1411 KETTNER BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2420
Practice Address - Country:US
Practice Address - Phone:619-231-7405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist