Provider Demographics
NPI:1336794130
Name:CHED NWAGWU MD PC
Entity Type:Organization
Organization Name:CHED NWAGWU MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHED
Authorized Official - Middle Name:
Authorized Official - Last Name:NWAGWU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-554-5112
Mailing Address - Street 1:31381 TRIGO TRL
Mailing Address - Street 2:
Mailing Address - City:TRABUCO CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:92679-3610
Mailing Address - Country:US
Mailing Address - Phone:949-554-5112
Mailing Address - Fax:
Practice Address - Street 1:26732 CROWN VALLEY PKWY STE 541
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6376
Practice Address - Country:US
Practice Address - Phone:949-388-7190
Practice Address - Fax:949-388-7150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty