Provider Demographics
NPI:1265000277
Name:OGHOGHORIE, EFE
Entity Type:Individual
Prefix:
First Name:EFE
Middle Name:
Last Name:OGHOGHORIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 30TH ST STE 130B
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3307
Mailing Address - Country:US
Mailing Address - Phone:510-969-7210
Mailing Address - Fax:510-562-0535
Practice Address - Street 1:431 30TH ST STE 130B
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3307
Practice Address - Country:US
Practice Address - Phone:510-969-7210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC2561410OtherMEDICAL TRANSPORTATION
CAC2561410Medicaid