Healthcare Provider Details

I. General information

NPI: 1053601419
Provider Name (Legal Business Name): CHINEDU INNOCENT AKABIKE PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CHINEDU INNOCENT AKABIKE RPH

II. Dates (important events)

Enumeration Date: 04/19/2011
Last Update Date: 04/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1735 E. WALNUT AVENUE
VISALIA CA
93292
US

IV. Provider business mailing address

1735 E WALNUT AVE
VISALIA CA
93292-1394
US

V. Phone/Fax

Practice location:
  • Phone: 559-625-3831
  • Fax: 559-625-3885
Mailing address:
  • Phone: 559-625-3831
  • Fax: 559-625-3885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH #63325
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: