Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
NDIKA FOMUKONG, P.A.C
ActiveNDIKA FOMUKONG, P.A.C is a Primary Care Nurse Practitioner healthcare provider located in KING CITY, California. NPI 1497700066 is currently active in the NPPES registry. Verify at CMS.
Primary Care Nurse Practitioner · KING CITY, CA
Registration Details
- NPI Number
- 1497700066
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 23, 2006 (20.260847003448 yrs)
- Last Updated
- Nov 20, 2013
- Licenses
-
PA17839 (CA)NP 17180 (CA)
Practice Information
- Address
-
210 CANAL STKING CITY, CA, 939303432Browse CA providers · Browse ZIP 93930
- Phone
- 8313855471
- Fax
- 8313855940
- Primary Specialty
-
Primary Care Nurse Practitioner
363LP2300X
- Additional Specialty
- Primary Care Nurse Practitioner
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.