Provider Demographics
NPI:1497821516
Name:ONYEADOR, EJIKE CELESTINE (MD)
Entity Type:Individual
Prefix:MR
First Name:EJIKE
Middle Name:CELESTINE
Last Name:ONYEADOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 ATLANTIC AVE
Mailing Address - Street 2:SUITE 715
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3408
Mailing Address - Country:US
Mailing Address - Phone:562-983-5496
Mailing Address - Fax:562-432-1864
Practice Address - Street 1:1045 ATLANTIC AVE
Practice Address - Street 2:SUITE 715
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3408
Practice Address - Country:US
Practice Address - Phone:562-983-5496
Practice Address - Fax:562-432-1864
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45589208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A455891OtherMEDICAL
CA00A455893Medicaid
E80519Medicare UPIN