Provider Demographics
NPI:1962689620
Name:AKPAMGBO, DOROTHY C
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:C
Last Name:AKPAMGBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6207 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-2434
Mailing Address - Country:US
Mailing Address - Phone:562-422-2163
Mailing Address - Fax:562-422-2578
Practice Address - Street 1:6207 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-2434
Practice Address - Country:US
Practice Address - Phone:562-422-2163
Practice Address - Fax:562-422-2578
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5985900001Medicare NSC