Provider Demographics
NPI:1962862813
Name:OBAROH, UZEZI JOSHUA
Entity Type:Individual
Prefix:MR
First Name:UZEZI
Middle Name:JOSHUA
Last Name:OBAROH
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:UZEZI
Other - Middle Name:JOSHUA
Other - Last Name:OBAROH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:21249 FIGUEROA ST
Mailing Address - Street 2:UNIT 4
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-1900
Mailing Address - Country:US
Mailing Address - Phone:310-430-2277
Mailing Address - Fax:
Practice Address - Street 1:21249 FIGUEROA ST
Practice Address - Street 2:UNIT 4
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-1900
Practice Address - Country:US
Practice Address - Phone:310-430-2277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily