Kehinde Paul Bankole, PHARMD
Individual provider Active NPI Pharmacist · Fair Oaks, CA
NPI 1083148134 · NPPES record last updated Apr 15, 2017
Key facts
- NPI
- 1083148134
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 73509 (CA)
- Practice address
- 8101 Greenback LN
Fair Oaks, CA 95628-2502 - Phone
- (916) 726-4466
- Fax
- (916) 726-4505
- NPI assigned
- Apr 15, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73509 | CA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 73509 | CA | Yes |
Addresses
Primary practice location
8101 Greenback LN
Fair Oaks, CA 95628-2502
Mailing address
8101 Greenback LN
Fair Oaks, CA 95628-2502
Phone (916) 726-4466
Other providers in Fair Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.