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Provider Information for 1376114843


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Miss MONICA UGOCHINYERE UKAOMA


Sex: Female

NPI: 1376114843
Last Updated: 2021-07-06
Certification Date: 2021-07-06

Details

NameValue
NPI1376114843
Enumeration Date2021-07-06
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 540 PARK AVE APT 1011
CLOVIS, CA 93611-6993
United States

Phone: 202-725-1607 | Fax:
 
Primary Practice Address 7300 N FRESNO ST
FRESNO, CA 93720-2942
United States

Phone: 559-448-4500 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 333600000X - Pharmacy CA