Provider Demographics
NPI:1902883085
Name:MORTON, DUDLEY CHAD (PHARMD)
Entity Type:Individual
Prefix:
First Name:DUDLEY
Middle Name:CHAD
Last Name:MORTON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 DORCHESTER CT
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-6230
Mailing Address - Country:US
Mailing Address - Phone:916-628-0227
Mailing Address - Fax:
Practice Address - Street 1:8 MEDICAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3106
Practice Address - Country:US
Practice Address - Phone:916-878-4960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA472001835X0200X
CA102671835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835X0200XPharmacy Service ProvidersPharmacistOncology