Provider Demographics
NPI:1063496164
Name:AKPOFURE, BLESSING (MD)
Entity Type:Individual
Prefix:
First Name:BLESSING
Middle Name:
Last Name:AKPOFURE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N TUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3807
Mailing Address - Country:US
Mailing Address - Phone:714-347-1010
Mailing Address - Fax:714-647-1245
Practice Address - Street 1:10921 CHERRY ST STE 100
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2473
Practice Address - Country:US
Practice Address - Phone:562-795-5600
Practice Address - Fax:562-795-5602
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75078207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A750780Medicaid
CA00A750781Medicaid
CAED821AMedicare PIN
COWA75078CMedicare PIN
CA00A750780Medicaid
CAWA75078AMedicare PIN
CA00A750781Medicaid
CAWA75078BMedicare PIN
CAED821BMedicare PIN
CAWA75078DMedicare PIN
CAG87065Medicare UPIN