Provider Demographics
NPI:1508874017
Name:NKWOCHA, OGUCHI (MD)
Entity Type:Individual
Prefix:
First Name:OGUCHI
Middle Name:
Last Name:NKWOCHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:440 AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-3302
Mailing Address - Country:US
Mailing Address - Phone:831-757-8689
Mailing Address - Fax:831-757-3721
Practice Address - Street 1:10561 MERRITT ST
Practice Address - Street 2:
Practice Address - City:CASTROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95012-3310
Practice Address - Country:US
Practice Address - Phone:831-633-1514
Practice Address - Fax:831-633-0311
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG47904207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAR734SMedicare PIN
CAA50856Medicare UPIN