Healthcare Provider Details

I. General information

NPI: 1831625938
Provider Name (Legal Business Name): KEEMPEE OBIAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2017
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29171 NEWPORT RD
MENIFEE CA
92584-2200
US

IV. Provider business mailing address

29171 NEWPORT RD
MENIFEE CA
92584-2200
US

V. Phone/Fax

Practice location:
  • Phone: 951-679-2245
  • Fax:
Mailing address:
  • Phone: 951-679-2245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60730253
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH89432
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: