Healthcare Provider Details

I. General information

NPI: 1568272664
Provider Name (Legal Business Name): TSIGEREDA MULUGETA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 ENTERPRISE BLVD
LEMOORE CA
93246-0001
US

IV. Provider business mailing address

3747 W NELLIS AVE
VISALIA CA
93277-0685
US

V. Phone/Fax

Practice location:
  • Phone: 559-998-4446
  • Fax:
Mailing address:
  • Phone: 559-942-1576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number89454
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: