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Individual

DR. IHEANACHO EMERUWA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9041 MAGNOLIA AVE, SUITE 305, RIVERSIDE, CA 92503-3900
(951) 343-3477
(951) 347-8343
Mailing address
9041 MAGNOLIA AVE, SUITE 305, RIVERSIDE, CA 92503-3900
(951) 343-3477
(951) 347-8343

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A41038
CA
207VX0000X
Obstetrics Physician
Primary
A41038
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A410380
CA
01
ZZZ28499Z
MEDICARE PTAN #
CA
Enumeration date
06/20/2005
Last updated
06/30/2021
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