Healthcare Provider Details

I. General information

NPI: 1740215854
Provider Name (Legal Business Name): TOCHUKWU O ONYEKWULUJE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 03/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4580 CALIFORNIA AVE
BAKERSFIELD CA
93309-1104
US

IV. Provider business mailing address

4580 CALIFORNIA AVE
BAKERSFIELD CA
93309-1104
US

V. Phone/Fax

Practice location:
  • Phone: 661-327-4411
  • Fax: 661-846-4859
Mailing address:
  • Phone: 661-327-4411
  • Fax: 661-846-4859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036094748
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036094748
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC53538
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: