Healthcare Provider Details

I. General information

NPI: 1750612719
Provider Name (Legal Business Name): CINDY UGOCHI NJEMANZE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2010
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5191 CHERRY AVE APT 1
LONG BEACH CA
90805-6243
US

IV. Provider business mailing address

5191 CHERRY AVE APT 1
LONG BEACH CA
90805-6243
US

V. Phone/Fax

Practice location:
  • Phone: 562-544-8059
  • Fax:
Mailing address:
  • Phone: 562-544-8059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA109906
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: