Provider Demographics
NPI:1104234764
Name:AWOSIKA, RUTH IDOWU (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:IDOWU
Last Name:AWOSIKA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8333 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-3607
Mailing Address - Country:US
Mailing Address - Phone:818-830-9846
Mailing Address - Fax:818-830-9076
Practice Address - Street 1:8333 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-3607
Practice Address - Country:US
Practice Address - Phone:818-830-9846
Practice Address - Fax:818-830-9076
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist