Provider Demographics
NPI:1457889974
Name:EMPRANTHIRI, MAYA (RPH)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:EMPRANTHIRI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 MERIDIAN AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-5318
Mailing Address - Country:US
Mailing Address - Phone:408-409-6874
Mailing Address - Fax:408-353-7175
Practice Address - Street 1:1530 MERIDIAN AVE STE 105
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5318
Practice Address - Country:US
Practice Address - Phone:408-409-6874
Practice Address - Fax:408-353-7175
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-29
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH50332183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW227481393OtherAETNA