Individual
ANTHONY I ODIMEGWU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
26062 BERCAW CT, MORENO VALLEY, CA 92555
(909) 255-5786
Mailing address
26062 BERCAW CT, MORENO VALLEY, CA 92555-1702
(909) 255-5786
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95006412
CA
Other
Enumeration date
08/16/2017
Last updated
07/21/2022
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