ODOCHI NWAGWU MD INC NPI 1174827125

NPI Information

NPI: 1174827125
Provider Name: ODOCHI NWAGWU MD INC

Doing Business As: SPECTRUM URGENT CARE

Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

Address:
15095 AMARGOSA RD
SUITE 280
VICTORVILLE, CA
ZIP 92394
Phone: (760) 952-9100
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ODOCHI NWAGWU MD INC is an urgent care clinic center in Victorville, CA. ODOCHI NWAGWU MD INC NPI is 1174827125. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Spectrum Urgent Care.

The provider's business location address is:

15095 AMARGOSA RD
SUITE 280
VICTORVILLE, CA
ZIP 92394-879
Phone: (760) 952-9100
Fax: (760) 952-9228

The provider's authorized official is Odochi N Nwagwu .
The authorized official title is Ceo and has the following contact phone number (760) 403-5571.

The enumeration date for this NPI number is 1/5/2011 and was last updated on 4/7/2011.

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
1	363A00000X	Physician Assistant		PA18372	CALIFORNIA	No
2	207R00000X	Internal Medicine		A84056	CALIFORNIA	No
3	261QU0200X	Clinic/Center	Urgent Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00G770491	MEDICAID	CALIFORNIA
2	4501031	MEDICARE PIN	CALIFORNIA
3	G65429	MEDICARE UPIN	CALIFORNIA
4	1225010903	OTHER	CALIFORNIA	NPPES

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: 4/28/2024

NPI Synchronization or Removal

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