Healthcare Provider Details

I. General information

NPI: 1023193455
Provider Name (Legal Business Name): MICHAEL M OKITA PHARM. D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25825 VERMONT AVE
HARBOR CITY CA
90710-3518
US

IV. Provider business mailing address

1065 S TIVOLI CT
ANAHEIM CA
92808-2441
US

V. Phone/Fax

Practice location:
  • Phone: 310-517-2244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number52389
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: