Provider Demographics
NPI:1366519522
Name:SAVITALA, MURTY (MS, M PHARM)
Entity type:Individual
Prefix:MR
First Name:MURTY
Middle Name:
Last Name:SAVITALA
Suffix:
Gender:M
Credentials:MS, M PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 GELSTON PL
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3044
Mailing Address - Country:US
Mailing Address - Phone:510-647-8100
Mailing Address - Fax:
Practice Address - Street 1:1051 HUME WAY
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-5558
Practice Address - Country:US
Practice Address - Phone:707-453-7342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR. PH 32575183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist