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NPI 1093076267

NPI 1093076267 : LINDA A OBEKPA-AGWADA MD : BRENTWOOD, CA

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General NPI Number Information
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    NPI Number           |    1093076267
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    Entity Type          |    Individual 
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    Provider Name        |    LINDA A OBEKPA-AGWADA MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/05/2012
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    Last Update Date     |    02/03/2020
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Provider Practice Location Address
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    Address Line         |    2400 BALFOUR RD STE 201 
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    City                 |    BRENTWOOD
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    State                |    CA
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    Zip                  |    94513-4952
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    Country              |    US
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    Telephone            |    925-308-8112
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    Fax                  |    925-308-8710
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Provider Business Mailing Address
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    Address Line         |    1450 TREAT BLVD # 300 
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    City                 |    WALNUT CREEK
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    State                |    CA
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    Zip                  |    94597-2168
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    Country              |    US
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    Telephone            |    925-952-2828
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    MT202067
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    License Number State |    PA
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Taxonomy #2
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    54656
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    License Number State |    CT
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Taxonomy #3
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    A148019
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    License Number State |    CA
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