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General NPI Number Information
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NPI Number | 1154366946
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Entity Type | Individual
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Provider Name | UDOH O OBIOHA MD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 980 N D ST
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City | SAN BERNARDINO
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State | CA
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Zip | 92410
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Country | US
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Telephone | 909-521-7509
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Fax | 909-521-7442
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Provider Business Mailing Address
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Address Line | 201 S BROADWAY
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City | SANTA ANA
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State | CA
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Zip | 92701-5633
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Country | US
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Telephone | 509-833-8330
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A42739
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License Number State | CA
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