MEDICARE: DBIA IGWE MEDICAL INC

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	208600000X	Surgery Physician	A53362	CA

General Provider Information

NPI Number	:	1538250139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DBIA IGWE MEDICAL INC

Provider Business Mailing Address
First Line	:	PO BOX 1198
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92564-1198
Country	:	US
Telephone Number	:	951-929-6260
Fax Number	:	951-765-2855

Provider Business Practice Location Address
First Line	:	36243 INLAND VALLEY DR
Second Line	:	# 60
City	:	WILDOMAR
State	:	CA
Zip	:	92595-9549
Country	:	US
Telephone Number	:	951-929-6260
Fax Number	:	951-765-2855

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANIEL IGWE JR.
Credential	:	M.D.
Telephone Number	:	951-929-6260

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	08/22/2020

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