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Contact Information

ANTHONY I ODIMEGWU
26062 BERCAW CT
MORENO VALLEY, CA92555
 Phone: 909-255-5786
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for ANTHONY I ODIMEGWU · (Male)

NPI Number 1063938603
Status Active
Credentials
Entity Individual
Enumeration date 08/16/2017
Last updated 07/21/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 95006412
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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