Organization
CHI DERMATOLOGY INC A PROFESSIONAL CORPORATION
Active
Organization
CHI DERMATOLOGY INC A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OGECHI IKEDIOBI MD, PHD (OWNER)
(941) 315-1099
Entity
Organization
Contact information
Practice address
120 LA CASA VIA STE 106-107, WALNUT CREEK, CA 94598-3067
(941) 315-1099
Mailing address
120 LA CASA VIA STE 106-107, WALNUT CREEK, CA 94598-3067
(941) 315-1099
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
05/31/2023
Last updated
06/01/2023
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