Provider Demographics
NPI:1346023991
Name:AZUBUIKE, UWA COMFORT KALU
Entity Type:Individual
Prefix:DR
First Name:UWA COMFORT
Middle Name:KALU
Last Name:AZUBUIKE
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 1:16465 SIERRA LAKES PKWY STE 275
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-1263
Mailing Address - Country:US
Mailing Address - Phone:909-702-4057
Mailing Address - Fax:
Practice Address - Street 1:16465 SIERRA LAKES PKWY STE 275
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-1263
Practice Address - Country:US
Practice Address - Phone:909-702-4057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF06230054363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily