Okwudiri Echegi

Individual provider Active NPI Medical Physician Assistant · Patterson, CA

NPI 1053908194 · NPPES record last updated Apr 27, 2021

Key facts

NPI
1053908194
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
PA59468 (CA)
Practice address
1444 Carly Creek Dr
Patterson, CA 95363-8764
Phone
(209) 605-6817
NPI assigned
Dec 23, 2020
Sex
Female
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1444 Carly Creek Dr
Patterson, CA 95363-8764

5901 W Century Blvd
Suite 750
Los Angeles, CA 90045-5443

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230106001871 CA Practitioner - Physician Assistant 1355711375

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA59468CAMDMedical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA59468 CA Yes

Addresses

Primary practice location

1444 Carly Creek Dr
Patterson, CA 95363-8764

Mailing address

1444 Carly Creek Dr
Patterson, CA 95363-8764
Phone (209) 605-6817

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Patterson

Other providers in Patterson, CA

All providers in Patterson, CA · Medical Physician Assistant in California

Sources for this page

Verify at the official NPI Registry.