Healthcare Provider Details

I. General information

NPI: 1326386962
Provider Name (Legal Business Name): CHIOMA PAULINE NWABUDE N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 E 4TH ST
LONG BEACH CA
90802-1831
US

IV. Provider business mailing address

1220 E 4TH ST
LONG BEACH CA
90802-1831
US

V. Phone/Fax

Practice location:
  • Phone: 580-484-1162
  • Fax: 855-712-7837
Mailing address:
  • Phone: 580-484-1162
  • Fax: 855-712-7837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number22715
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: