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General NPI Number Information
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NPI Number | 1659553709
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Entity Type | Individual
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Provider Name | CHUKWEUMEKA CHIKWENDU OD
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Gender | Male
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 12/04/2015
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Provider Practice Location Address
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Address Line | 7743 WEST LN SUITE A2
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City | STOCKTON
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State | CA
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Zip | 95210-3348
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Country | US
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Telephone | 209-636-4914
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Fax | 209-208-1819
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Provider Business Mailing Address
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Address Line | 7743 WEST LN SUITE A-2
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City | STOCKTON
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State | CA
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Zip | 95210-3348
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Country | US
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Telephone | 209-636-4914
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Fax | 209-208-1819
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT 13449
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License Number State | CA
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