MEDICARE: DR. IFEANYI G OGUELI RPH, PHD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	62134	CA
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	11591	CA

General Provider Information

NPI Number	:	1801269568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IFEANYI G OGUELI RPH, PHD.

Provider Business Mailing Address
First Line	:	12221 CARSON ST
Second Line	:
City	:	HAWAIIAN GARDENS
State	:	CA
Zip	:	90716-1601
Country	:	US
Telephone Number	:	562-568-7011
Fax Number	:

Provider Business Practice Location Address
First Line	:	12221 E CARSON STREET
Second Line	:
City	:	HAWAIIAN GARDENS
State	:	CA
Zip	:	90716-1601
Country	:	US
Telephone Number	:	562-568-7011
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2015
Last Update Date	:	06/10/2025

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