Provider Demographics
NPI:1861614976
Name:ODELUGA, NDUKWE NWORA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:NDUKWE
Middle Name:NWORA
Last Name:ODELUGA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:11101 MYERS RANCH CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-2898
Mailing Address - Country:US
Mailing Address - Phone:661-301-0679
Mailing Address - Fax:661-665-9381
Practice Address - Street 1:1500 CADET RD
Practice Address - Street 2:TAFT CORRECTIONAL INSTITUTION, HEALTH SERVICES UNIT
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-4800
Practice Address - Country:US
Practice Address - Phone:661-763-2510
Practice Address - Fax:661-765-3010
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA76572207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH54042Medicare UPIN
CA00A765720Medicare ID - Type Unspecified