Provider Demographics
NPI:1811279979
Name:OKEKE, IFEYINWA U
Entity type:Individual
Prefix:
First Name:IFEYINWA
Middle Name:U
Last Name:OKEKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11930 STUDEBAKER RD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-7548
Mailing Address - Country:US
Mailing Address - Phone:562-864-8138
Mailing Address - Fax:562-929-8489
Practice Address - Street 1:11930 STUDEBAKER RD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-7548
Practice Address - Country:US
Practice Address - Phone:562-864-8138
Practice Address - Fax:562-929-8489
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57818183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist