Healthcare Provider Details

I. General information

NPI: 1154790194
Provider Name (Legal Business Name): REMIGIUS MGBOJIRIKWE R.PH, PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: REMY MGBOJIRIKWE

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1704 W. MANCHESTER BLVD STE 100
LOS ANGELES CA
90047-3056
US

IV. Provider business mailing address

3627 MANHATTAN BEACH BLVD
LAWNDALE CA
90260-2410
US

V. Phone/Fax

Practice location:
  • Phone: 323-753-1333
  • Fax: 323-753-1335
Mailing address:
  • Phone: 310-403-1693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 43754
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: