Individual
MR. CHIDOZIE EPHREM IBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2620 26TH AVE, OAKLAND, CA 94601-1907
(510) 437-2363
Mailing address
1172 ROXANNE AVE, HAYWARD, CA 94542-1051
(408) 386-9403
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95014912
CA
Other
Enumeration date
10/02/2020
Last updated
10/02/2020
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