Individual
MR. EMMANUEL O OGBODO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MBA,, PA-C
Contact information
Practice address
229 W 7TH ST, SAN JACINTO, CA 92583-4662
(951) 487-2550
Mailing address
27216 BARK LN, MORENO VALLEY, CA 92555-4749
(323) 481-8386
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA19357
CA
Other
Enumeration date
06/29/2009
Last updated
06/29/2009
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