1770872434 NPI number — EUGENE CHUKWUDI ECHEGI B. PHARM.

Table of content: DR. YAN WU OD (NPI 1538266465)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770872434 NPI number — EUGENE CHUKWUDI ECHEGI B. PHARM.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ECHEGI
Provider First Name:
EUGENE
Provider Middle Name:
CHUKWUDI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
B. PHARM.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770872434
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1239 E A ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKDALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95361-2714
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-408-5465
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1449 E F ST
Provider Second Line Business Practice Location Address:
FOOTHILL SHOPPING COMPLEX, SUITE 102
Provider Business Practice Location Address City Name:
OAKDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95361-9265
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-847-4279
Provider Business Practice Location Address Fax Number:
209-848-3210
Provider Enumeration Date:
04/04/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  65175 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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