Provider Demographics
NPI:1467452920
Name:VASOYA, CHHAGAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHHAGAN
Middle Name:
Last Name:VASOYA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5096 CARTILLA AVE
Mailing Address - Street 2:
Mailing Address - City:ALTA LOMA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-1791
Mailing Address - Country:US
Mailing Address - Phone:909-980-6688
Mailing Address - Fax:909-398-1291
Practice Address - Street 1:5096 CARTILLA AVE
Practice Address - Street 2:
Practice Address - City:ALTA LOMA
Practice Address - State:CA
Practice Address - Zip Code:91737-1791
Practice Address - Country:US
Practice Address - Phone:909-980-6688
Practice Address - Fax:909-398-1291
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40846183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA435400Medicaid
CAPHA435400Medicaid