Healthcare Provider Details

I. General information

NPI: 1689153512
Provider Name (Legal Business Name): ELENA ION OPRIS PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3240 ARDEN WAY
SACRAMENTO CA
95864-9586
US

IV. Provider business mailing address

3991 RILEY ANTON WAY
RANCHO CORDOVA CA
95742-8001
US

V. Phone/Fax

Practice location:
  • Phone: 916-225-8609
  • Fax:
Mailing address:
  • Phone: 916-225-8609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number77965
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: