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General NPI Number Information
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NPI Number | 1659011518
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Entity Type | Individual
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Provider Name | ZACK OJINAGA RCEP
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Gender | Male
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Dates
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Enumeration Date | 03/30/2022
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 10471 GRANT LINE RD STE 170
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City | ELK GROVE
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State | CA
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Zip | 95624-5073
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Country | US
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Telephone | 916-883-3366
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Fax |
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Provider Business Mailing Address
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Address Line | 3408 TRIO LN
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City | SACRAMENTO
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State | CA
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Zip | 95817-2071
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Country | US
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Telephone | 559-920-0119
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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 | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number | 1066004
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License Number State | CA
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