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Organization
CAMELIA C WOGU MD LTD
Active
Organization
CAMELIA C WOGU MD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI LABRECQUE (ACCTS MGR)
(702) 453-3799
Entity
Organization
Contact information
Practice address
300 CANAL ST, KING CITY, CA 93930-3431
(702) 453-3799
(702) 453-5741
Mailing address
3380 LA SIERRA AVE STE 104-613, RIVERSIDE, CA 92503-5271
(951) 367-5586
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
19686
MT
208M00000X
Hospitalist Physician
Primary
A102408
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19686
MT LIC
MT
01
—
A102408
CA LIC
CA
Enumeration date
05/07/2013
Last updated
10/02/2018
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