Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | A52415 | CA |
NPI | 1013131390 |
---|---|
Provider Name | Dr. Boniface O Onubah |
First Address | Westminster, CA 92683-4791 |
Second Address | Westminster, CA 92683-4791 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F72015 | (02) | CA |