MEDICARE: ANGELA IFEOMA BENTUM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency		CA

General Provider Information

NPI Number	:	1457213910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA IFEOMA BENTUM

Provider Business Mailing Address
First Line	:	2308 9TH AVE APT C
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94606-2760
Country	:	US
Telephone Number	:	510-600-9889
Fax Number	:

Provider Business Practice Location Address
First Line	:	2308 9TH AVE APT C
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94606-2760
Country	:	US
Telephone Number	:	510-600-9889
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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Directions to “ ANGELA IFEOMA BENTUM ” Practice Location

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