Kenneth Ejiogu (NPI# 1639647019, PAC ID# 5597099028) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1639647019 |
| PAC ID by PECOS | 5597099028 |
| Professional Enrollment ID | I20190702003455 |
| Full Name | Kenneth Ejiogu |
| Organization Legal Name | LAGS SPINE AND SPORTSCARE MEDICAL CENTERS INC |
| Address |
801 E Chapel St Santa Maria CA 93454-4607 |
| Phone Number | 8059287361 |
| Gender | M |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 8426028069 |
| Number of Group Practice Members | 46 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050121 | ADVENTIST HEALTH HANFORD |
| Address | Phone | Organization |
|---|---|---|
| 801 E Chapel St, Santa Maria, CA 93454-4607 | 8059287361 | LAGS SPINE AND SPORTSCARE MEDICAL CENTERS INC |
| Organization Legal Name | LAGS SPINE AND SPORTSCARE MEDICAL CENTERS INC |
| Physicians | 47 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael They | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 3550 Q St, Bakersfield, CA 93301-1645 |
| Manli Huang | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 945 Blanco Cir, Suite A, Salinas, CA 93901-4421 |
| Analene Z Cesar | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 510 W 25th St, Merced, CA 95340-2802 |
| Brianna L Hoffmann | Physical Medicine and Rehabilitation | Lags Spine and Sportscare Medical Centers Inc | 169 Ne 102nd Ave, Portland, OR 97220-4169 |
| Femi B Obanor | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 349 E Bullard Ave, Suite 105, Fresno, CA 93710-5298 |
| Krisztina Herrera | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 4080 Loma Vista Rd, Suite F, Ventura, CA 93003-1811 |
| Matthew Hadilaksono | Physical Medicine and Rehabilitation | Lags Spine and Sportscare Medical Centers Inc | 801 E Chapel St, Suite 1, Santa Maria, CA 93454-4607 |
| Kendra N Brown Walker | Physical Medicine and Rehabilitation | Lags Spine and Sportscare Medical Centers Inc | 2651 S C St, Suite 200, Oxnard, CA 93033-3560 |
| Heliodoro M Magana | Physician Assistant | Lags Spine and Sportscare Medical Centers Inc | 218 N I St, Lompoc, CA 93436-0909 |
| Olivia A Seibenick | Physician Assistant | Lags Spine and Sportscare Medical Centers Inc | 2362 N Oxnard Blvd, Oxnard, CA 93036-2053 |
| Street Address |
801 E CHAPEL ST |
| City | SANTA MARIA |
| State | CA |
| Zip | 93454-4607 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew Hadilaksono | Physical Medicine and Rehabilitation | Lags Spine and Sportscare Medical Centers Inc | 801 E Chapel St, Suite 1, Santa Maria, CA 93454-4607 |
| Mitra Delshad | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 801 E Chapel St, Suite 1, Santa Maria, CA 93454-4607 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jane P O Brien | Certified Registered Nurse Anesthetist (crna) | 816 E Ehos Dr B, Santa Maria, CA 93454 | |
| Ramanand C Dandillaya | Neurology | 210 S Palisade S Dr, Suite 203, Santa Maria, CA 93454 | |
| Gayle L Ulshafer | Certified Registered Nurse Anesthetist | 837 Harper Ct, Santa Maria, CA 93454-2348 | |
| James Tahmisian | Psychologist, Clinical | 117 E Fesler St, Santa Maria, CA 93454-4404 | |
| Ron T Ng | Optometry | 610 E Chapel St, Suite C, Santa Maria, CA 93454-4522 | |
| Arlene C Gonzales | Family Medicine | 722 E Chapel St, Santa Maria, CA 93454-4524 | |
| Nathan Singer | Interventional Pain Management | 120 N Miller St A, Santa Maria, CA 93454-4557 | |
| Wanda J Spencer | Obstetrics/gynecology | 937 E Main St, 101 Women Care, Santa Maria, CA 93454-4607 | |
| Kristin M Savage | Occupational Therapy | Coastal Hand and Occupational Therapy | 201 N College Dr, Suite 203, Santa Maria, CA 93454-4614 |
| Kenneth D Channer | Physical Therapy | 201 N College Dr, Suite 203, Santa Maria, CA 93454-4614 | |
| Find all physicians in zip 93454 | |||
| City | SANTA MARIA |
| Zip Code | 93454 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | SANTA MARIA + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Kenneth Ejiogu.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.