Provider Demographics
NPI:1699002550
Name:EZE, NWANDO UCHENNA (MD)
Entity Type:Individual
Prefix:DR
First Name:NWANDO
Middle Name:UCHENNA
Last Name:EZE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BALLARD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-1682
Mailing Address - Country:US
Mailing Address - Phone:530-400-0784
Mailing Address - Fax:
Practice Address - Street 1:455 S. MAIN STREET
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3874
Practice Address - Country:US
Practice Address - Phone:714-997-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103608208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics