Provider Demographics
NPI:1720508724
Name:MONAZZA NAVID CHAUDHRY LLC
Entity Type:Organization
Organization Name:MONAZZA NAVID CHAUDHRY LLC
Other - Org Name:A&O PENINSULA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONAZZA
Authorized Official - Middle Name:NAVID
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:650-692-6569
Mailing Address - Street 1:1860 EL CAMINO REAL STE 108
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3106
Mailing Address - Country:US
Mailing Address - Phone:650-692-6569
Mailing Address - Fax:650-692-6569
Practice Address - Street 1:1860 EL CAMINO REAL STE 108
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3106
Practice Address - Country:US
Practice Address - Phone:650-692-6569
Practice Address - Fax:650-692-6569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1902039878OtherNPI