Provider Demographics
NPI:1669908174
Name:MORIOKA, GREGG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GREGG
Middle Name:
Last Name:MORIOKA
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 1:7465 RUSH RIVER DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-5255
Mailing Address - Country:US
Mailing Address - Phone:916-391-1289
Mailing Address - Fax:916-391-7847
Practice Address - Street 1:7465 RUSH RIVER DR
Practice Address - Street 2:SUITE 500
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-5255
Practice Address - Country:US
Practice Address - Phone:916-391-1289
Practice Address - Fax:916-391-7847
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist