Provider Demographics
NPI:1457770836
Name:ORJI, UCHENNA G (FNP-C)
Entity Type:Individual
Prefix:
First Name:UCHENNA
Middle Name:G
Last Name:ORJI
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 OCEANGATE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4317
Mailing Address - Country:US
Mailing Address - Phone:562-499-6191
Mailing Address - Fax:877-778-9427
Practice Address - Street 1:24853 ALESSANDRO BLVD, #4
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-6102
Practice Address - Country:US
Practice Address - Phone:951-571-8518
Practice Address - Fax:877-778-9427
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95000577363LF0000X
CA95000577363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP01490861OtherRAILROAD MEDICARE-DU4034
CAP01490861OtherRAILROAD MEDICARE-DU4034