Emmanuel O Ogbodo, MBA,, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA19357 Issued in CA

Practice address

229 W 7TH St
San Jacinto, CA 92583-4662

Phone

(951) 487-2550

NPI assigned

Jun 29, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration

State licenses

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1326276353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27216 BARK LN",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554749",
            "telephone_number": "323-481-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W 7TH ST",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925834662",
            "telephone_number": "951-487-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBODO",
        "first_name": "EMMANUEL",
        "middle_name": "O",
        "name_prefix": "Mr.",
        "credential": "MBA,, PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA19357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Frederick Casareo Obmina Josue, RN
• David Ochoa
• Jose Ochoa Jr., CADCII, ICADC
• Noemi Ochoa
• Vanessa Ochoa
• Oxana Ogiwara, LMT
• Georgenia Okere, NP-C
• Adaeze Okoh
• Taiwo Olawuyi
• Linda S. Olson, NP

• Medical Physician Assistant in San Jacinto, CA
• Providers in San Jacinto, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; 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.