Provider Demographics
NPI:1164786414
Name:CHINDA, RICHARD KOCHO
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:KOCHO
Last Name:CHINDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 BROOKE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1861
Mailing Address - Country:US
Mailing Address - Phone:202-415-8310
Mailing Address - Fax:
Practice Address - Street 1:2403 BROOKE GROVE RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1861
Practice Address - Country:US
Practice Address - Phone:202-415-8310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide