Oyesumbo Oluwafunke Idowu

Individual provider Active NPI Pharmacist · Stevenson Ranch, CA

NPI 1275937906 · NPPES record last updated Oct 9, 2014

Key facts

NPI
1275937906
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
47480 (CA)
Practice address
25450 The Old Rd
Stevenson Ranch, CA 91381-1704
Phone
(661) 253-2357
Fax
(661) 253-4247
NPI assigned
Oct 9, 2014
Sex
Female
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

State licenses

LicenseStateTypeSpecialty
47480CAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 47480 CA Yes

Addresses

Primary practice location

25450 The Old Rd
Stevenson Ranch, CA 91381-1704

Mailing address

26916 Terri Dr
Canyon Country, CA 91351-4821
Phone (661) 373-8239

Other providers in Stevenson Ranch, CA

All providers in Stevenson Ranch, CA · Pharmacist in California

Sources for this page

Verify at the official NPI Registry.