Provider Demographics
NPI:1508896275
Name:OTUECHERE, VALENTINE U (MD, MPH)
Entity Type:Individual
Prefix:
First Name:VALENTINE
Middle Name:U
Last Name:OTUECHERE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8990 GARFIELD ST STE 6
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3922
Mailing Address - Country:US
Mailing Address - Phone:951-343-1616
Mailing Address - Fax:951-343-1666
Practice Address - Street 1:8990 GARFIELD ST STE 6
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3922
Practice Address - Country:US
Practice Address - Phone:951-343-1616
Practice Address - Fax:951-343-1666
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93662207R00000X, 208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine