Provider Demographics
NPI:1447579131
Name:MADAKI, HARUNA NGBO (BPHARM, MPH)
Entity Type:Individual
Prefix:MR
First Name:HARUNA
Middle Name:NGBO
Last Name:MADAKI
Suffix:
Gender:M
Credentials:BPHARM, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 MAYFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-1210
Mailing Address - Country:US
Mailing Address - Phone:916-333-1125
Mailing Address - Fax:
Practice Address - Street 1:295 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3691
Practice Address - Country:US
Practice Address - Phone:530-662-1795
Practice Address - Fax:530-662-6261
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 61015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist