Provider Demographics
NPI:1386184588
Name:OKS, VALERIJ
Entity Type:Individual
Prefix:
First Name:VALERIJ
Middle Name:
Last Name:OKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 PLAYA VISTA DR
Mailing Address - Street 2:APT 1
Mailing Address - City:PLAYA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:90094-2157
Mailing Address - Country:US
Mailing Address - Phone:323-316-6021
Mailing Address - Fax:
Practice Address - Street 1:5350 PLAYA VISTA DR
Practice Address - Street 2:APT 1
Practice Address - City:PLAYA VISTA
Practice Address - State:CA
Practice Address - Zip Code:90094-2157
Practice Address - Country:US
Practice Address - Phone:323-316-6021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75912183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist