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General NPI Number Information
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NPI Number | 1356169833
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Entity Type | Individual
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Provider Name | CHERYL WISSEH MADU PHARMD, MPH
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Gender | Female
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 800 N MAIN ST
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City | SANTA ANA
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State | CA
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Zip | 92701-3576
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Country | US
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Telephone | 714-210-7230
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Fax |
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Provider Business Mailing Address
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Address Line | 802 W PELTASON DRIVE
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City | IRVINE
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State | CA
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Zip | 92697-4625
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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 | 78202
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 6153846
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License Number State | CA
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