Healthcare Provider Details

I. General information

NPI: 1285933044
Provider Name (Legal Business Name): DANIEL EMENIKE OGBUEHI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2011
Last Update Date: 03/19/2011
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

6690 N IVANHOE AVE
FRESNO CA
93722-3051
US

V. Phone/Fax

Practice location:
  • Phone: 559-846-7115
  • Fax:
Mailing address:
  • Phone: 559-974-0672
  • Fax: 559-846-9756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberCA46755
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: