Active NPI
Clem Ajayi, RPH
- Pharmacist
- Victorville, CA
National Provider Identifier
1871659052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 046140
- Practice address
- 14829 7TH St
Suite E
Victorville, CA 92395-4009 - Phone
- (760) 245-3518
- Fax
- (760) 245-1662
- NPI assigned
- Dec 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 046140 | CA | Primary |
Addresses
Primary practice location
14829 7TH St
Suite E
Victorville, CA 92395-4009
Mailing address
12798 Bay Summit Way
Victorville, CA 92392-7964
Phone (760) 949-8955
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046140 | Other | CA | CAL LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046140 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adokiye Enterprises | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871659052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12798 BAY SUMMIT WAY",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923927964",
"telephone_number": "760-949-8955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14829 7TH ST",
"address_2": "SUITE E",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923954009",
"telephone_number": "760-245-3518",
"fax_number": "760-245-1662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AJAYI",
"first_name": "CLEM",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "046140",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAL LICENSE NUMBER",
"identifier": "046140",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.