Individual
DR. VINCENT EDE AJANWACHUKU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16133 KAMANA RD, APPLE VALLEY, CA 92307-1377
(760) 242-8491
(760) 242-8495
Mailing address
16133 KAMANA RD, APPLE VALLEY, CA 92307-1377
(760) 242-8491
(760) 242-8495
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A437360
CA
2086S0127X
Trauma Surgery Physician
A437360
CA
2086X0206X
Surgical Oncology Physician
A437360
CA
208C00000X
Colon & Rectal Surgery Physician
A437360
CA
Other
Enumeration date
11/07/2006
Last updated
02/22/2016
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