Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | A169546 | CA |
NPI | 1205360591 |
---|---|
Provider Name | Dr. Mukuka Kangwa |
First Address | Oakland, CA 94609-1809 |
Second Address | Oakland, CA 94609-1809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2017 |
Last Update Date | 24/08/2020 |