Provider Demographics
NPI:1740536168
Name:SEWOATSRI, RICHARD ADJETEY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ADJETEY
Last Name:SEWOATSRI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 BOULDER DR
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-4480
Mailing Address - Country:US
Mailing Address - Phone:415-652-5036
Mailing Address - Fax:
Practice Address - Street 1:2511 BOULDER DR
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301
Practice Address - Country:US
Practice Address - Phone:415-652-5036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist