Provider Demographics
NPI:1154790194
Name:MGBOJIRIKWE, REMIGIUS (RPH, PHARMD)
Entity type:Individual
Prefix:
First Name:REMIGIUS
Middle Name:
Last Name:MGBOJIRIKWE
Suffix:
Gender:M
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:REMY
Other - Middle Name:
Other - Last Name:MGBOJIRIKWE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3627 MANHATTAN BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2410
Mailing Address - Country:US
Mailing Address - Phone:310-403-1693
Mailing Address - Fax:
Practice Address - Street 1:1704 W. MANCHESTER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90047-3056
Practice Address - Country:US
Practice Address - Phone:323-753-1333
Practice Address - Fax:323-753-1335
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-21
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 43754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist