Provider Demographics
NPI:1952415838
Name:OKEZIE, ONYINYE (MD)
Entity type:Individual
Prefix:
First Name:ONYINYE
Middle Name:
Last Name:OKEZIE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 OLD RIVER RD STE 110
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9509
Mailing Address - Country:US
Mailing Address - Phone:661-370-0777
Mailing Address - Fax:661-654-8366
Practice Address - Street 1:8501 BRIMHALL RD BLDG 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2327
Practice Address - Country:US
Practice Address - Phone:661-370-0777
Practice Address - Fax:661-654-8366
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93885208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1700414398Medicaid