Individual provider Active NPI

Eugene Nkem Odega

  • Non-emergency Medical Transport (VAN)
  • Gardena, CA
National Provider Identifier
1093981029
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Practice address
1204 W Gardena Blvd Ste B
Gardena, CA 90247-5923
Phone
(310) 962-7922
Fax
(310) 767-7835
NPI assigned
Apr 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

1204 W Gardena Blvd Ste B
Gardena, CA 90247-5923

Mailing address

1204 W Gardena Blvd Ste B
Gardena, CA 90247-5923
Phone (310) 962-7922

Other identifiers 1

IdentifierTypeStateIssuer
49321OtherCAHOME MEDICAL DEVICE RETAIL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Odes Medical Transportation , LLC Non-Emergency Medical Transport (Van) Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1093981029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 W GARDENA BLVD STE B",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902475923",
            "telephone_number": "310-962-7922",
            "fax_number": "323-757-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 W GARDENA BLVD STE B",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902475923",
            "telephone_number": "310-962-7922",
            "fax_number": "310-767-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEGA",
        "first_name": "EUGENE",
        "middle_name": "NKEM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME MEDICAL DEVICE RETAIL LICENSE",
            "identifier": "49321",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.