Provider Demographics
NPI:1154366987
Name:OKWUJE, EMEKA BERNARD (MD)
Entity type:Individual
Prefix:
First Name:EMEKA
Middle Name:BERNARD
Last Name:OKWUJE
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 1:2650 CAMINO DEL RIO N
Mailing Address - Street 2:SUITE 355
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1621
Mailing Address - Country:US
Mailing Address - Phone:619-851-6997
Mailing Address - Fax:619-374-2427
Practice Address - Street 1:2650 CAMINO DEL RIO N
Practice Address - Street 2:SUITE 355
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1621
Practice Address - Country:US
Practice Address - Phone:619-851-6997
Practice Address - Fax:619-347-2427
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81449207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA81449OtherMEDICAL LICENSE
H90484Medicare UPIN