Individual
DR. FOMBE NDIFORCHU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
454 E CARSON PLAZA DR, SUITE 110, CARSON, CA 90746-3209
(310) 516-0742
(310) 516-9158
Mailing address
454 E CARSON PLAZA DR, SUITE 110, CARSON, CA 90746-3209
(310) 516-0742
(310) 516-9158
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
A26721
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A267210
—
CA
Enumeration date
07/19/2006
Last updated
07/09/2007
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