Individual
NKEM OBIAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10074 MUD HEN WAY, ELK GROVE, CA 95757-6422
(916) 340-4414
Mailing address
10074 MUD HEN WAY, ELK GROVE, CA 95757-6422
(916) 340-4414
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
675598
CA
183500000X
Pharmacist
RPH63675
CA
Other
Enumeration date
12/21/2011
Last updated
02/25/2019
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