Provider Demographics
NPI:1043418759
Name:ANAKWENZE, OKE ADRIAN (MD)
Entity Type:Individual
Prefix:
First Name:OKE
Middle Name:ADRIAN
Last Name:ANAKWENZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 CONVOY ST 201
Mailing Address - Street 2:OLYMPIC ORTHOPEDICS
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-3770
Mailing Address - Country:US
Mailing Address - Phone:858-300-2260
Mailing Address - Fax:858-569-1337
Practice Address - Street 1:3750 CONVOY ST STE 201
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-3770
Practice Address - Country:US
Practice Address - Phone:858-300-2260
Practice Address - Fax:858-300-2260
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT190910207X00000X
CAA126807207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery