Healthcare Provider Details

I. General information

NPI: 1629391677
Provider Name (Legal Business Name): MAUREEN C OKORO PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2010
Last Update Date: 02/25/2022
Certification Date: 02/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5161 CALIFORNIA AVE STE 100
IRVINE CA
92617-8002
US

IV. Provider business mailing address

5161 CALIFORNIA AVE STE 100
IRVINE CA
92617-8002
US

V. Phone/Fax

Practice location:
  • Phone: 888-843-5779
  • Fax:
Mailing address:
  • Phone: 888-843-5779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02925200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number049547
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number52597
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: