Provider Demographics
NPI:1679867865
Name:PAI, SUCHETA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SUCHETA
Middle Name:
Last Name:PAI
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 1:8800 WHITTIER BLVD
Mailing Address - Street 2:T1425
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-2658
Mailing Address - Country:US
Mailing Address - Phone:562-949-6133
Mailing Address - Fax:562-949-6133
Practice Address - Street 1:8800 WHITTIER BLVD
Practice Address - Street 2:T1425
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-2658
Practice Address - Country:US
Practice Address - Phone:562-949-6133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-05
Last Update Date:2011-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist