Individual
COLLIN A MBANUGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3300 WEBSTER ST, SUITE 900, OAKLAND, CA 94609-3117
(510) 272-9610
(510) 272-9612
Mailing address
3300 WEBSTER ST, SUITE 900, OAKLAND, CA 94609-3117
(510) 272-9610
(510) 272-9612
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
00C411000
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C411000
—
CA
Enumeration date
01/17/2007
Last updated
01/13/2016
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