Provider Demographics
NPI:1851752968
Name:AYUBYAR, OGGAI (PHARMD)
Entity Type:Individual
Prefix:
First Name:OGGAI
Middle Name:
Last Name:AYUBYAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4209 N MONTEGO LN
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-4692
Mailing Address - Country:US
Mailing Address - Phone:510-676-9742
Mailing Address - Fax:
Practice Address - Street 1:22 TERRACED HILLS WAY
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-9102
Practice Address - Country:US
Practice Address - Phone:510-676-9742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist