Provider Demographics
NPI:1538572045
Name:BHUCHAR, VENITA (PHARMD)
Entity type:Individual
Prefix:
First Name:VENITA
Middle Name:
Last Name:BHUCHAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 MONTANA AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-5955
Mailing Address - Country:US
Mailing Address - Phone:713-447-7474
Mailing Address - Fax:
Practice Address - Street 1:1202 MONTANA AVE STE C
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5955
Practice Address - Country:US
Practice Address - Phone:713-447-7474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68512183500000X
TX54268183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist