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NPI Code Detail

MEDICARE: OMOROGBE NORENSE IGBINEWEKA

MEDICARE: OMOROGBE NORENSE IGBINEWEKA
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
1163WG0100XGastroenterology Registered Nurse824217CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1824217OTHERCARN LICENSE

General Provider Information

NPI Number : 1619509809
Entity Type Code : Individual
Provider Name (Legal Business Name) : OMOROGBE NORENSE IGBINEWEKA
Provider Business Mailing Address
First Line : 1411 E 31ST ST
Second Line :
City : OAKLAND
State : CA
Zip : 94602-1018
Country : US
Telephone Number : 510-860-6726
Fax Number :
Provider Business Practice Location Address
First Line : 1411 E 31ST ST
Second Line :
City : OAKLAND
State : CA
Zip : 94602-1018
Country : US
Telephone Number : 510-437-7396
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2020
Last Update Date : 02/06/2020

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Directions to “ OMOROGBE NORENSE IGBINEWEKA ” Practice Location

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