Provider Demographics
NPI:1285758417
Name:KOFI D SEFA-BOAKYE , MD INC
Entity type:Organization
Organization Name:KOFI D SEFA-BOAKYE , MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:KOFI
Authorized Official - Middle Name:DABO
Authorized Official - Last Name:SEFA-BOAKYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-422-2121
Mailing Address - Street 1:10 PORT ROYAL
Mailing Address - Street 2:
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118
Mailing Address - Country:US
Mailing Address - Phone:619-575-7700
Mailing Address - Fax:
Practice Address - Street 1:344 E H STREET
Practice Address - Street 2:SUITE 1402
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910
Practice Address - Country:US
Practice Address - Phone:619-422-2121
Practice Address - Fax:619-422-2427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG59670207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty