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NPI Code Detail

MEDICARE: MR. CHRISTOPHER A CHIGBOLU R.N

MEDICARE:  MR. CHRISTOPHER A CHIGBOLU  R.N
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0808XPsychiatric/Mental Health Registered Nurse625185CA

General Provider Information

NPI Number : 1841372463
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRISTOPHER A CHIGBOLU R.N
Provider Business Mailing Address
First Line : 5624 VALLEY GLEN WAY
Second Line :
City : LOS ANGELES
State : CA
Zip : 90043-2122
Country : US
Telephone Number : 323-292-1210
Fax Number :
Provider Business Practice Location Address
First Line : 10605 BALBOA BLVD STE 100
Second Line :
City : GRANADA HILLS
State : CA
Zip : 91344-6367
Country : US
Telephone Number : 818-832-2410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 07/08/2007

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Directions to “ MR. CHRISTOPHER A CHIGBOLU R.N” Practice Location

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