Provider Demographics
NPI:1699945485
Name:GOGINENI, HYMA P (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HYMA
Middle Name:P
Last Name:GOGINENI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2376 JEAN MARIE CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-6988
Mailing Address - Country:US
Mailing Address - Phone:951-898-1618
Mailing Address - Fax:909-558-0234
Practice Address - Street 1:11262 CAMPUS STREET
Practice Address - Street 2:WEST HALL
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350
Practice Address - Country:US
Practice Address - Phone:909-558-7818
Practice Address - Fax:909-558-0234
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52129183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist