Provider Demographics
NPI:1528650256
Name:IFEJIKA, ILEKA CHIBUZO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ILEKA
Middle Name:CHIBUZO
Last Name:IFEJIKA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 W 35TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007-3444
Mailing Address - Country:US
Mailing Address - Phone:415-515-0772
Mailing Address - Fax:
Practice Address - Street 1:1151 S HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-6840
Practice Address - Country:US
Practice Address - Phone:714-773-0841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80431183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist