Individual
CHINWE IDIKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
204 HAMPTON DR, VENICE, CA 90291-8633
(310) 396-6468
Mailing address
204 HAMPTON DR, VENICE, CA 90291-8633
(310) 396-8402
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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