Individual
CHINEDU E EBOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7420 SONG SPARROW WAY, ELK GROVE, CA 95758-1236
(972) 820-8136
Mailing address
7420 SONG SPARROW WAY, ELK GROVE, CA 95758
(972) 820-8136
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
VN242177
CA
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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