Provider Demographics
NPI:1437902913
Name:OKE, SAMSONDEEN
Entity Type:Individual
Prefix:
First Name:SAMSONDEEN
Middle Name:
Last Name:OKE
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 1:2335 SANTA ANA S
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90059-1344
Mailing Address - Country:US
Mailing Address - Phone:424-644-5432
Mailing Address - Fax:
Practice Address - Street 1:2335 SANTA ANA S
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059-1344
Practice Address - Country:US
Practice Address - Phone:424-644-5432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle