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General NPI Number Information
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NPI Number | 1497913735
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Entity Type | Individual
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Provider Name | CHIKA PAMELLA UDOH-ESOMONU M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 07/31/2012
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Provider Practice Location Address
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Address Line | 901 CAMPUS DRIVE SUITE 102
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City | DALY CITY
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State | CA
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Zip | 94015-4930
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Country | US
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Telephone | 650-991-2000
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Fax | 650-755-8638
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Provider Business Mailing Address
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Address Line | 202 STONE PINE CT
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City | HERCULES
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State | CA
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Zip | 94547-2676
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Country | US
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Telephone | 510-691-1816
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Fax | 510-245-3244
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A104151
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License Number State | CA
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