Healthcare Provider Details

I. General information

NPI: 1255745485
Provider Name (Legal Business Name): DENNIS ELEK RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 06/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 S MADERA AVE
KERMAN CA
93630-1538
US

IV. Provider business mailing address

1248 E LOMA LINDA AVE
FRESNO CA
93720-2667
US

V. Phone/Fax

Practice location:
  • Phone: 559-846-7115
  • Fax: 559-846-9756
Mailing address:
  • Phone: 559-917-9301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH27007
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: