Provider Demographics
NPI:1265860167
Name:DURU, CHIDI R (NP)
Entity Type:Individual
Prefix:
First Name:CHIDI
Middle Name:R
Last Name:DURU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:200 OCEANGATE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4317
Mailing Address - Country:US
Mailing Address - Phone:909-428-0170
Mailing Address - Fax:877-778-9312
Practice Address - Street 1:17500 FOOTHILL BLVD
Practice Address - Street 2:A-2
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-3798
Practice Address - Country:US
Practice Address - Phone:909-428-0170
Practice Address - Fax:877-778-9312
Is Sole Proprietor?:No
Enumeration Date:2013-10-31
Last Update Date:2015-04-23
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Provider Licenses
StateLicense IDTaxonomies
CA23292363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily