Provider Demographics
NPI:1114342623
Name:ATWAL, HERJOT KAUR (PHARMD)
Entity Type:Individual
Prefix:
First Name:HERJOT
Middle Name:KAUR
Last Name:ATWAL
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 1:440 BLOSSOM HILL RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-1608
Mailing Address - Country:US
Mailing Address - Phone:408-229-8013
Mailing Address - Fax:
Practice Address - Street 1:440 BLOSSOM HILL RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-1608
Practice Address - Country:US
Practice Address - Phone:408-229-8013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69058183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist