Healthcare Provider Details

I. General information

NPI: 1457164485
Provider Name (Legal Business Name): ONEIRO MANAGEMENT GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8026 LORRAINE AVE STE 207
STOCKTON CA
95210-4224
US

IV. Provider business mailing address

8026 LORRAINE AVE STE 207
STOCKTON CA
95210-4224
US

V. Phone/Fax

Practice location:
  • Phone: 209-298-1715
  • Fax: 559-369-2408
Mailing address:
  • Phone: 209-298-1715
  • Fax: 559-369-2408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PRATAP KRISHNA ANNE
Title or Position: PHARMACY DIRECTOR
Credential:
Phone: 209-298-1715