Provider Demographics
NPI:1396285698
Name:AKPOROTU, AKPOBO (MD)
Entity type:Individual
Prefix:DR
First Name:AKPOBO
Middle Name:
Last Name:AKPOROTU
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 1:495 E RINCON ST STE 208
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-1379
Mailing Address - Country:US
Mailing Address - Phone:951-523-0117
Mailing Address - Fax:
Practice Address - Street 1:9939 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3528
Practice Address - Country:US
Practice Address - Phone:855-745-8600
Practice Address - Fax:951-758-8858
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA179694207RN0300X
282N00000X
NJ25MA11507400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No282N00000XHospitalsGeneral Acute Care Hospital