Individual ProviderMike Onu UdohGeneral PracticeAllopathic & Osteopathic PhysiciansPractice Address34800 Bob Wilson Dr, San Diego, CA 92134-1098(502) 852-8696PECOS EnrollmentBased on the most recent information from CMS, provider Mike Onu Udoh does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1700468782Provider TypeIndividualFull NameUdoh, Mike OnuCredentialMDGenderMaleSole ProprietorYesEnumeration Date4/28/2021Last Updated6/16/2025Contact InformationPractice LocationPractice Address34800 Bob Wilson Dr, San Diego, CA 92134-1098Phone(502) 852-8696FaxUnlisted FaxMailing LocationMailing Address34800 Bob Wilson Dr, San Diego, CA 92134-1098PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208D00000XPrimaryDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicense198280CaliforniaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer