MR. ANTHONY OGBODO NPI 1063884625

NPI Information

  • NPI: 1063884625
  • Provider Name: MR. ANTHONY OGBODO
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2471 NORTH NAGLEE ROAD
    SUITE 100 #1037
    TRACY, CA
    ZIP 95304
  • Phone: (510) 755-3004

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NPI Details

MR. Anthony Ogbodo is a family nurse practitioner in Tracy, CA. MR. Anthony Ogbodo NPI is 1063884625. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2471 NORTH NAGLEE ROAD
SUITE 100 #1037
TRACY, CA
ZIP 95304-519
Phone: (510) 755-3004

The NPI 1063884625 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/22/2015 and was last updated on 12/12/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily95002864CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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