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General NPI Number Information
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NPI Number | 1568606697
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Entity Type | Organization
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Legal Business Name | CHINEDUM PEDIATRIC HEALTH PA
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Dates
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Enumeration Date | 04/20/2009
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Last Update Date | 04/20/2009
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Provider Practice Location Address
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Address Line | 910 E REDD RD STE P
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City | EL PASO
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State | TX
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Zip | 79912-7348
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Country | US
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Telephone | 915-351-6600
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Fax | 915-351-6601
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Provider Business Mailing Address
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Address Line | 910 E REDD RD STE P
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City | EL PASO
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State | TX
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Zip | 79912-7348
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Country | US
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Telephone | 915-351-6600
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Fax | 915-351-6601
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Authorized Official
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Title or Position | PRESIDENT
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Name | FLORENCE O NNEBE
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Credential | MD
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Telephone | 915-351-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0201X
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Taxonomy Name | Pediatric Allergy/Immunology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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