Provider Demographics
NPI:1326696329
Name:DIJEH, UCHECHUKWU NKIRU (UCHEY DIJEH)
Entity Type:Individual
Prefix:
First Name:UCHECHUKWU
Middle Name:NKIRU
Last Name:DIJEH
Suffix:
Gender:F
Credentials:UCHEY DIJEH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5203 CAMINITO CACHORRO
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-5357
Mailing Address - Country:US
Mailing Address - Phone:619-376-0824
Mailing Address - Fax:
Practice Address - Street 1:5203 CAMINITO CACHORRO
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-5357
Practice Address - Country:US
Practice Address - Phone:619-376-0824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health