Provider Demographics
NPI:1811217847
Name:IKEGBU, JUDE EMEKA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JUDE
Middle Name:EMEKA
Last Name:IKEGBU
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9441 CRENSHAW BLVD
Mailing Address - Street 2:APT. 2
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-2984
Mailing Address - Country:US
Mailing Address - Phone:310-404-6466
Mailing Address - Fax:310-532-2216
Practice Address - Street 1:13141 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-4416
Practice Address - Country:US
Practice Address - Phone:310-973-8250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58181183500000X
PA441026183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist