Provider Demographics
NPI:1811628969
Name:EZEJI, UCHECHUKWU (RN)
Entity Type:Individual
Prefix:
First Name:UCHECHUKWU
Middle Name:
Last Name:EZEJI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 N MONTEREY AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-3318
Mailing Address - Country:US
Mailing Address - Phone:951-505-5812
Mailing Address - Fax:
Practice Address - Street 1:550 N MONTEREY AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-3318
Practice Address - Country:US
Practice Address - Phone:951-505-5812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95151838163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice