Provider Demographics
NPI:1770606451
Name:CHAUGULE, JAMEEL EBRAHIM (R PH)
Entity type:Individual
Prefix:MR
First Name:JAMEEL
Middle Name:EBRAHIM
Last Name:CHAUGULE
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12937 HEDDA ST
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-6110
Mailing Address - Country:US
Mailing Address - Phone:562-809-5205
Mailing Address - Fax:
Practice Address - Street 1:10751 NOEL ST
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2547
Practice Address - Country:US
Practice Address - Phone:714-816-9047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56997183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist