Provider Demographics
NPI:1821399940
Name:LECHUGA, MITCHELL D
Entity Type:Individual
Prefix:MR
First Name:MITCHELL
Middle Name:D
Last Name:LECHUGA
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 1:450 S VENTURA RD
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-6557
Mailing Address - Country:US
Mailing Address - Phone:805-240-7994
Mailing Address - Fax:805-240-7889
Practice Address - Street 1:450 S VENTURA RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-6557
Practice Address - Country:US
Practice Address - Phone:805-240-7994
Practice Address - Fax:805-240-7889
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 36731183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist