Healthcare Provider Details

I. General information

NPI: 1659554509
Provider Name (Legal Business Name): ADANNA O IKEDILO MD, FACOG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ADANNA O NJOKU MD

II. Dates (important events)

Enumeration Date: 12/14/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1374 E ALLUVIAL AVE
FRESNO CA
93720-2608
US

IV. Provider business mailing address

1374 E ALLUVIAL AVE
FRESNO CA
93720-2608
US

V. Phone/Fax

Practice location:
  • Phone: 559-981-2600
  • Fax: 559-981-2610
Mailing address:
  • Phone: 559-981-2600
  • Fax: 559-981-2610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA116330
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: