Provider Demographics
NPI:1174241376
Name:ONWUKA, ONYEBUCHI
Entity type:Individual
Prefix:MR
First Name:ONYEBUCHI
Middle Name:
Last Name:ONWUKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 STURGEON ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94130-1643
Mailing Address - Country:US
Mailing Address - Phone:510-508-0849
Mailing Address - Fax:
Practice Address - Street 1:1705 CHANSLOR AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-3643
Practice Address - Country:US
Practice Address - Phone:925-664-7809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)