Eugene I. Emembolu, M.D., Inc.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G28708 Issued in CA

Legal business name

EUGENE I. EMEMBOLU, M.D., INC.

Practice address

399 E. Highland Avenue
Suite 506
San Bernardino, CA 92404-3865

Phone

(909) 882-1711

Fax

(909) 881-1431

NPI assigned

Jul 27, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Eugene Ikem Emembolu, M.D.

Title

Owner

Phone

(909) 882-1711

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343347200000",
    "number": "1043566029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 E. HIGHLAND AVENUE",
            "address_2": "SUITE 506",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043865",
            "telephone_number": "909-882-1711",
            "fax_number": "909-881-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E. HIGHLAND AVENUE",
            "address_2": "SUITE 506",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043865",
            "telephone_number": "909-882-1711",
            "fax_number": "909-881-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENE I. EMEMBOLU, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-27",
        "last_updated": "2012-07-27",
        "status": "A",
        "authorized_official_last_name": "EMEMBOLU",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "IKEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-882-1711",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G28708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.