Provider Demographics
NPI:1194067215
Name:SEFA BOAKYE, MAMIE SARPOMA (MD)
Entity type:Individual
Prefix:DR
First Name:MAMIE
Middle Name:SARPOMA
Last Name:SEFA BOAKYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MAAME
Other - Middle Name:AKOSUA SARPOMA
Other - Last Name:SEFA-BOAKYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:211 BROOKS ST UNIT 1545
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92051-7024
Mailing Address - Country:US
Mailing Address - Phone:619-202-5663
Mailing Address - Fax:
Practice Address - Street 1:1000 VALE TERRACE DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-5218
Practice Address - Country:US
Practice Address - Phone:760-631-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA137549207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine