Individual
MR. OSAMAMWODE SUNDAY OGBEIWI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
101 W CENTRAL AVE, SUITE B120, BREA, CA 92821-7515
(714) 709-3154
Mailing address
954 BARBARA LN, POMONA, CA 91767-4118
(714) 709-3154
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
17752
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
17752
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17752
FNP-BC
CA
01
—
2007010341
FNP - ANCC
CA
Enumeration date
03/12/2008
Last updated
11/17/2023
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