Individual
DR. IKEMEFUNA IKEM EZEDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
34800 BOB WILSON DR DEPT OF, SAN DIEGO, CA 92134-1098
(619) 532-9795
Mailing address
34800 BOB WILSON DR DEPT OF, SAN DIEGO, CA 92134-1098
(619) 532-9795
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0102204201
VA
208D00000X
General Practice Physician
Primary
0102204201
VA
Other
Enumeration date
06/13/2014
Last updated
03/17/2026
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