Provider Demographics
NPI:1821484502
Name:COREGENE USA, LLC
Entity Type:Organization
Organization Name:COREGENE USA, LLC
Other - Org Name:COREGENE ADVISORS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHONNIUSS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEMWENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-816-8014
Mailing Address - Street 1:18100 VON KARMAN AVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-0169
Mailing Address - Country:US
Mailing Address - Phone:949-705-4644
Mailing Address - Fax:
Practice Address - Street 1:18100 VON KARMAN AVE
Practice Address - Street 2:SUITE 850
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-0169
Practice Address - Country:US
Practice Address - Phone:949-705-4644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage