Provider Demographics
NPI:1861927907
Name:OKEREKE, NKECHINYERE (RPH)
Entity type:Individual
Prefix:
First Name:NKECHINYERE
Middle Name:
Last Name:OKEREKE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8731 LOS COYOTES DR
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-1027
Mailing Address - Country:US
Mailing Address - Phone:714-926-6778
Mailing Address - Fax:714-735-8632
Practice Address - Street 1:1 ORCHARD
Practice Address - Street 2:# 145
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-8337
Practice Address - Country:US
Practice Address - Phone:714-243-4104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist