Provider Demographics
NPI:1275386526
Name:ONYENEHO, CYNTHIA CHINONSO
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:CHINONSO
Last Name:ONYENEHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 DORSEY PLACE CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-8709
Mailing Address - Country:US
Mailing Address - Phone:770-940-6253
Mailing Address - Fax:
Practice Address - Street 1:11975 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2540
Practice Address - Country:US
Practice Address - Phone:770-940-6253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH034755183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist