Provider Demographics
NPI:1164823233
Name:SAKHARELIYA, PIYUSH
Entity Type:Individual
Prefix:
First Name:PIYUSH
Middle Name:
Last Name:SAKHARELIYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 TREEMONT PL APT 207
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-7861
Mailing Address - Country:US
Mailing Address - Phone:530-415-5607
Mailing Address - Fax:
Practice Address - Street 1:2230 TREEMONT PL
Practice Address - Street 2:APT#207
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879
Practice Address - Country:US
Practice Address - Phone:530-415-5607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70942183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist