Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ida Osathanugrah

Individual provider Pharmacist · NPI 1205558707

Ida Osathanugrah is a Pharmacist in Clovis, California. Licensed in California. Registered with an NPI since 2022.

Licensed in
CA
In the registry since
2022

Practice location Address checks out

2010 Los Altos Ave
Clovis, CA 93611-5309
Phone: (661) 557-3800
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 86494 (CA)

Record details

NPI number1205558707
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 13, 2022
Last updated in NPPESSeptember 13, 2022
Certification dateSeptember 13, 2022
Mailing address2010 Los Altos Ave, Clovis, CA 93611-5309

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