Provider Demographics
NPI:1467159590
Name:UHUNMWANGHO, OGHOGHO (NP)
Entity Type:Individual
Prefix:
First Name:OGHOGHO
Middle Name:
Last Name:UHUNMWANGHO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 SCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-5309
Mailing Address - Country:US
Mailing Address - Phone:831-208-4416
Mailing Address - Fax:
Practice Address - Street 1:191 PHELPS AVE
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210
Practice Address - Country:US
Practice Address - Phone:559-821-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023249363LF0000X
CANP95023249207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily