1346467370

Everything you always wanted to know about DR. OMALU IFEAKANDU BENNET M.D., M.B.A., M.P.H. but were afraid to ask.

DR. OMALU IFEAKANDU BENNET M.D., M.B.A., M.P.H.

You can also download the this 1346467370 data report as csv | excel | json | xml
Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential
DR. OMALU IFEAKANDU BENNET M.D., M.B.A., M.P.H.
Gender:
Male
Enumeration date:
2007-04-19
Last update date:
2012-01-25
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
202C00000X Independent Medical Examiner CA C52868 Y
207ZC0006X Clinical Pathology CA C52868 N
207ZF0201X Forensic Pathology CA C52868 N
207ZN0500X Neuropathology CA C52868 N
207ZP0101X Anatomic Pathology CA C52868 N
207ZP0102X Anatomic Pathology & Clinical Pathology CA C52868 N
209800000X Legal Medicine CA C52868 N

Phone Numbers

Type Number
Practice Location Address Telephone Number 9167342525
Mailing Address Telephone Number 2097129092
Mailing Address Fax Number 8664026875
Practice Location Address Fax Number 8664026875

Addresses

Type Address City State Postal Country
Mailing Address 1132 JUNEWOOD CT UNIVERSITY OF CALIFORNIA, DAVIS, MEDICAL CENTER LODI CA 95242 CA
Practice Location Address 4400 V STREET SACRAMENTO CA 95817 CA

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