# NTIEDO JOHNSON INYANG

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lifeline Medical Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649284589
- **Authorized official:** MR. NTIEDO JOHNSON INYANG (OWNER / CEO)
- **Authorized official phone:** (510) 595-8474

## Contact information

- **Practice address:** 3139 SAN PABLO AVE, OAKLAND, CA 94608-4533
- **Practice address phone:** (510) 595-8474
- **Practice address fax:** (510) 595-8410
- **Mailing address:** 3139 SAN PABLO AVE, OAKLAND, CA 94608-4533
- **Mailing address phone:** (510) 595-8474
- **Mailing address fax:** (510) 595-8410

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 103425 | CA | Yes |

## Other

- **Enumeration date:** 07/28/2006
- **Last updated:** 07/14/2008