Provider Demographics
NPI:1982326609
Name:ACHIRI, MATHURIN MOKOM (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:MATHURIN
Middle Name:MOKOM
Last Name:ACHIRI
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17051 BEAR VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-1845
Mailing Address - Country:US
Mailing Address - Phone:760-948-7901
Mailing Address - Fax:
Practice Address - Street 1:17051 BEAR VALLEY RD
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-1845
Practice Address - Country:US
Practice Address - Phone:760-948-7901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86857183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist