Provider Demographics
NPI:1922021914
Name:NWANODI, OROMA BEATRICE AFIONG (MD)
Entity Type:Individual
Prefix:MS
First Name:OROMA
Middle Name:BEATRICE AFIONG
Last Name:NWANODI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OROMA
Other - Middle Name:BEATRICE
Other - Last Name:NWANODI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:770 THE CITY DR S STE 4000
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4929
Mailing Address - Country:US
Mailing Address - Phone:714-620-3000
Mailing Address - Fax:714-740-1833
Practice Address - Street 1:1150 N INDIAN CANYON DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4872
Practice Address - Country:US
Practice Address - Phone:760-323-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006017607207V00000X
WY7239A207V00000X
NY2350311207V00000X
CAC55184207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA122181OtherMEDICARE PTAN
MO121695300Medicaid
138262Medicare UPIN
MO121695300Medicaid