Provider Demographics
NPI:1164796637
Name:FUJIWARA, JERRY I (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:I
Last Name:FUJIWARA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 CALIFORNIA AVE
Mailing Address - Street 2:#68
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1152
Mailing Address - Country:US
Mailing Address - Phone:661-334-2056
Mailing Address - Fax:
Practice Address - Street 1:5055 CALIFORNIA AVE
Practice Address - Street 2:#320
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0701
Practice Address - Country:US
Practice Address - Phone:661-334-2056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA364421835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist