Theodora Ewusi-Mensah, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A31536 Issued in CA

Practice address

304 West F Street
Ontario, CA 91762-3206

Phone

(909) 983-4746

NPI assigned

Aug 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Theodora Abaka Acquaah Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679689194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FRANCISCAN PLACE",
            "city": "PHILLIPS RANCH",
            "state": "CA",
            "postal_code": "917664867",
            "telephone_number": "909-983-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 WEST F STREET",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623206",
            "telephone_number": "909-983-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWUSI-MENSAH",
        "first_name": "THEODORA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A31536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A315360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THEODORA",
            "last_name": "ACQUAAH",
            "middle_name": "ABAKA",
            "credential": "MBCHB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pediatrics Physician in Ontario, CA
• Providers in Ontario, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.