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General NPI Number Information
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NPI Number | 1417873696
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Entity Type | Organization
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Legal Business Name | EGBOSIUBA MD PSYCHIATRY, INC.
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Dates
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Enumeration Date | 06/24/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 851 FREMONT AVE STE 108
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City | LOS ALTOS
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State | CA
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Zip | 94024-5602
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Country | US
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Telephone | 650-262-1564
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Fax |
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Provider Business Mailing Address
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Address Line | 851 FREMONT AVE STE 108
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City | LOS ALTOS
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State | CA
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Zip | 94024-5602
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Country | US
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Telephone | 650-262-1564
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | LINDA CHINELO EGBOSIUBA
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Credential | MD, MBA
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Telephone | 650-262-1564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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