Provider Demographics
NPI:1972899797
Name:PULANCO, CHERYL (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:PULANCO
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 1:133 SERRAMONTE CTR
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2349
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:133 SERRAMONTE CTR
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2349
Practice Address - Country:US
Practice Address - Phone:650-755-4668
Practice Address - Fax:650-755-4668
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist