Individual
DR. EMMANUEL NOSA OBANOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
999 S FAIRMONT AVE, SUITE 125, LODI, CA 95240-5100
(209) 334-8514
(209) 366-2661
Mailing address
PO BOX 241011, LODI, CA 95241-9511
(209) 339-7435
(209) 333-3054
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A6988
CA
207RG0100X
Gastroenterology Physician
Primary
20A6988
CA
Other
Enumeration date
06/09/2006
Last updated
04/04/2017
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