Provider Demographics
NPI:1639227143
Name:ANANE-SEFAH, JOHN CAMARA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CAMARA
Last Name:ANANE-SEFAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 CAPITOLA AVE
Mailing Address - Street 2:
Mailing Address - City:CAPITOLA
Mailing Address - State:CA
Mailing Address - Zip Code:95010-2751
Mailing Address - Country:US
Mailing Address - Phone:831-476-5403
Mailing Address - Fax:831-476-4107
Practice Address - Street 1:603 CAPITOLA AVE
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-2751
Practice Address - Country:US
Practice Address - Phone:831-476-5403
Practice Address - Fax:831-476-4107
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG23854208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Not Answered208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG23854OtherMD LICENSE
CAGR0030290Medicaid
CAGR0030290Medicaid
AA7563249OtherDEA
A23088Medicare UPIN