Provider Demographics
NPI:1386345122
Name:NJOROGE, GEORGE
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:NJOROGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 EXPOSITION BLVD APT 444
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-5138
Mailing Address - Country:US
Mailing Address - Phone:530-785-9642
Mailing Address - Fax:
Practice Address - Street 1:1501 EXPOSITION BLVD APT 444
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-5138
Practice Address - Country:US
Practice Address - Phone:530-785-9642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF3487471342000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company