MEDICARE: PAUL OGECHUKWUNYEM NKADI MD1

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	208100000X	Physical Medicine & Rehabilitation Physician	A139131	CA

General Provider Information

NPI Number	:	1861787426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL OGECHUKWUNYEM NKADI MD1

Provider Business Mailing Address
First Line	:	5489 E SUNWOOD CT
Second Line	:
City	:	ROCKLIN
State	:	CA
Zip	:	95677-3053
Country	:	US
Telephone Number	:	510-552-6807
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 K ST
Second Line	:	120-C
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-5124
Country	:	US
Telephone Number	:	916-448-1770
Fax Number	:

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

Provider Enumeration Date	:	06/12/2011
Last Update Date	:	01/07/2016

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