Provider Demographics
NPI:1346027521
Name:OZONNADI, CHUKWUDI
Entity Type:Individual
Prefix:
First Name:CHUKWUDI
Middle Name:
Last Name:OZONNADI
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 1:1803 E FERNROCK ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-2538
Mailing Address - Country:US
Mailing Address - Phone:424-200-9626
Mailing Address - Fax:
Practice Address - Street 1:901 SILVER SPUR RD
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3805
Practice Address - Country:US
Practice Address - Phone:310-377-6728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88344183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist