Healthcare Provider Details

I. General information

NPI: 1720200488
Provider Name (Legal Business Name): SULEIMAN JANGIKHAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 W CHANNEL ISLANDS BLVD
PORT HUENEME CA
93041-2130
US

IV. Provider business mailing address

5048 SEALANE WAY
OXNARD CA
93035-1967
US

V. Phone/Fax

Practice location:
  • Phone: 805-985-2326
  • Fax: 805-984-0882
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number56056
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: