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NPI Code Detail

MEDICARE: MERCY EGBUJOR NP

MEDICARE:   MERCY  EGBUJOR  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner481610CA
2363LA2200XAdult Health Nurse Practitioner481610CA
3363LC1500XCommunity Health Nurse Practitioner481610CA

General Provider Information

NPI Number : 1326001439
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERCY EGBUJOR NP
Provider Business Mailing Address
First Line : 751 S BASCOM AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95128-2604
Country : US
Telephone Number : 408-885-5000
Fax Number :
Provider Business Practice Location Address
First Line : 2011 LITTLE ORCHARD ST
Second Line : PUENTES CLINIC-INTERNAL MEDICINE
City : SAN JOSE
State : CA
Zip : 95125-1031
Country : US
Telephone Number : 408-294-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 09/14/2007

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Directions to “ MERCY EGBUJOR NP” Practice Location

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