Provider Demographics
NPI:1205155306
Name:NJAKA, PATRICK A (RPH)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:A
Last Name:NJAKA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11350 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3631
Mailing Address - Country:US
Mailing Address - Phone:818-760-7300
Mailing Address - Fax:818-760-7735
Practice Address - Street 1:11350 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3631
Practice Address - Country:US
Practice Address - Phone:818-760-7300
Practice Address - Fax:818-760-7735
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46348183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist