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General NPI Number Information
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NPI Number | 1154639102
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Entity Type | Individual
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Provider Name | SALLY T OYENUGA
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Gender | Female
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 3760 MOWRY AVE
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City | FREMONT
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State | CA
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Zip | 94538-1428
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Country | US
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Telephone | 510-894-0552
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Fax | 510-894-0713
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Provider Business Mailing Address
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Address Line | 32895 BLUEBIRD COURT
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City | FREMONT
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State | CA
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Zip | 94555
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Country | US
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Telephone | 510-552-7913
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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 | 46875
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License Number State | CA
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