Healthcare Provider Details

I. General information

NPI: 1205155306
Provider Name (Legal Business Name): PATRICK A NJAKA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2010
Last Update Date: 05/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11350 VICTORY BLVD
NORTH HOLLYWOOD CA
91606-3631
US

IV. Provider business mailing address

11350 VICTORY BLVD
NORTH HOLLYWOOD CA
91606-3631
US

V. Phone/Fax

Practice location:
  • Phone: 818-760-7300
  • Fax: 818-760-7735
Mailing address:
  • Phone: 818-760-7300
  • Fax: 818-760-7735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number46348
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: