Provider Demographics
NPI:1437460177
Name:ASUQUO, STELLA EDET (MD)
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:EDET
Last Name:ASUQUO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2500 MOWRY AVE STE 255
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1605
Mailing Address - Country:US
Mailing Address - Phone:510-248-1000
Mailing Address - Fax:510-608-6055
Practice Address - Street 1:39141 CIVIC CENTER DR STE 335
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-5878
Practice Address - Country:US
Practice Address - Phone:510-248-1420
Practice Address - Fax:510-791-2874
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2022-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA1568382086S0129X
284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
No284300000XHospitalsSpecial HospitalGroup - Single Specialty