Provider Demographics
NPI:1477989010
Name:SOJITRA, GOPAL D (PHARMD)
Entity Type:Individual
Prefix:
First Name:GOPAL
Middle Name:D
Last Name:SOJITRA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10400 ARROW RTE
Mailing Address - Street 2:APT O-09
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4772
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10400 ARROW RTE
Practice Address - Street 2:APT O-09
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4772
Practice Address - Country:US
Practice Address - Phone:862-251-2153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-14
Last Update Date:2013-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69070183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist