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General NPI Number Information
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NPI Number | 1134618960
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Entity Type | Individual
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Provider Name | ANNE THERESE OKOLO RPH
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Gender | Female
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 1540 W FOOTHILL BLVD
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City | UPLAND
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State | CA
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Zip | 91786-3653
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Country | US
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Telephone | 909-920-0942
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Fax |
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Provider Business Mailing Address
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Address Line | 101 W MISSION BLVD STE 110-205
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City | POMONA
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State | CA
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Zip | 91766-1711
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 67049
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License Number State | CA
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