Provider Demographics
NPI:1508959990
Name:A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:TOGBA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:510-763-7415
Mailing Address - Street 1:3300 WEBSTER STREET
Mailing Address - Street 2:STE 1109
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609
Mailing Address - Country:US
Mailing Address - Phone:510-763-7415
Mailing Address - Fax:510-763-7844
Practice Address - Street 1:3300 WEBSTER STREET
Practice Address - Street 2:STE 1109
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609
Practice Address - Country:US
Practice Address - Phone:510-763-7415
Practice Address - Fax:510-763-7844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA04342502086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A48348Medicare UPIN