Healthcare Provider Details

I. General information

NPI: 1861787426
Provider Name (Legal Business Name): PAUL OGECHUKWUNYEM NKADI MD1
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2011
Last Update Date: 01/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 K ST 120-C
SACRAMENTO CA
95816-5124
US

IV. Provider business mailing address

5489 E SUNWOOD CT
ROCKLIN CA
95677-3053
US

V. Phone/Fax

Practice location:
  • Phone: 916-448-1770
  • Fax:
Mailing address:
  • Phone: 510-552-6807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberA139131
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: