Healthcare Provider Details

I. General information

NPI: 1932034550
Provider Name (Legal Business Name): CHRIS OKWUOSA MD, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11755 MALAGA DR UNIT 1109
RANCHO CUCAMONGA CA
91730-8126
US

IV. Provider business mailing address

11755 MALAGA DR UNIT 1109
RANCHO CUCAMONGA CA
91730-8126
US

V. Phone/Fax

Practice location:
  • Phone: 310-850-6804
  • Fax:
Mailing address:
  • Phone: 310-850-6804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRIS OKWUOSA
Title or Position: SURGEON/PRESIDENT
Credential: MD
Phone: 310-850-6804