Healthcare Provider Details

I. General information

NPI: 1265000277
Provider Name (Legal Business Name): EFE OGHOGHORIE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 30TH ST STE 130B
OAKLAND CA
94609-3307
US

IV. Provider business mailing address

431 30TH ST STE 130B
OAKLAND CA
94609-3307
US

V. Phone/Fax

Practice location:
  • Phone: 510-969-7210
  • Fax:
Mailing address:
  • Phone: 510-969-7210
  • Fax: 510-562-0535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: