Individual
MUCHANETA MADUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR, CHT
Contact information
Practice address
5360 JACKSON DR STE 110, LA MESA, CA 91942-3012
(619) 667-7000
(619) 667-4315
Mailing address
5360 JACKSON DR STE 110, LA MESA, CA 91942-3012
(619) 667-7000
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
4565
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023103330
NPI NUMBER
CA
Enumeration date
04/04/2007
Last updated
09/08/2020
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