Augustine Atiyota, PHARMD
Individual provider Active NPI Pharmacist · Blythe, CA
NPI 1235476367 · NPPES record last updated Jan 9, 2013
Key facts
- NPI
- 1235476367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 46883 (CA)
- Practice address
- 1345 W Hobsonway
Blythe, CA 92225-1425 - Phone
- (760) 921-2017
- Fax
- (760) 921-2020
- NPI assigned
- Jan 9, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 46883 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Austin'S Pharmacy Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 46883 | CA | Yes |
Addresses
Primary practice location
1345 W Hobsonway
Blythe, CA 92225-1425
Mailing address
740 Oleander LN
Blythe, CA 92225-1322
Phone (760) 922-5966
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B3980609 | Other | CA | STATE OF CALIFORNIA |
Other names
- Dr. Augustine Atiyota
Other providers in Blythe, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2013. 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.