Ogechukwu Achufusi

Individual provider Active NPI Registered Nurse · Fontana, CA

NPI 1124576483 · NPPES record last updated Sep 15, 2016

Key facts

NPI
1124576483
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
624332 (CA)
Practice address
6177 Eaglemont Dr
Fontana, CA 92336-5817
Phone
(310) 404-5961
NPI assigned
Sep 15, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
624332CAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 624332 CA Yes

Addresses

Primary practice location

6177 Eaglemont Dr
Fontana, CA 92336-5817

Mailing address

6177 Eaglemont Dr
Fontana, CA 92336-5817
Phone (310) 404-5961

Other providers in Fontana, CA

All providers in Fontana, CA · Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.