MEDICARE: FUNMI ADERETI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	47629	CA

General Provider Information

NPI Number	:	1922673144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FUNMI ADERETI

Provider Business Mailing Address
First Line	:	PO BOX 1136
Second Line	:
City	:	PLACENTIA
State	:	CA
Zip	:	92871-1136
Country	:	US
Telephone Number	:	714-376-3546
Fax Number	:

Provider Business Practice Location Address
First Line	:	43875 WASHINGTON ST STE A
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-8249
Country	:	US
Telephone Number	:	760-777-9902
Fax Number	:	760-777-9820

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2021
Last Update Date	:	05/20/2021

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Directions to “ FUNMI ADERETI ” Practice Location

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