Sopuruchi Maryanne Obialasor

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

7018 Blair Rd
Calipatria, CA 92233-9633

Phone

(760) 348-7000

NPI assigned

Sep 16, 2024

Last updated

Sep 16, 2024By the provider in NPPES

Sex

Female

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

Practice roles

Locations

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

• Corrections and Rehabilitation-Headquarters

  dba Calipatria State Prison

  • Pharmacy
  • Calipartia, CA
  • NPI 1265067086
  NPD

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1740017797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7018 BLAIR RD",
            "city": "CALIPATRIA",
            "state": "CA",
            "postal_code": "922339633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7018 BLAIR RD",
            "city": "CALIPATRIA",
            "state": "CA",
            "postal_code": "922339633",
            "telephone_number": "760-348-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBIALASOR",
        "first_name": "SOPURUCHI",
        "middle_name": "MARYANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alberto Acevesl Lopez, F.N.P
• Ashley Marie Martinez
• Jaime A Martinez
• David Franklin Middleton, PHD
• Shahida Naz, M.D.
• Sun Kwa Oh, M.D.
• Jeff E Oostyen, PSY.D.
• Jose Martin Penilla, DENTIST D.D.S
• Acxell F Ramirez, SUD COUNSELOR
• Ezriana Marie Ruiz

• Student in an Organized Health Care Education/Training Program in Calipatria, CA
• Providers in Calipatria, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.