Provider Demographics
NPI:1750705703
Name:CHUKWUNTA, ANTHONY IFEDIORA
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:IFEDIORA
Last Name:CHUKWUNTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 BEECHWOOD ST APT 48
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-6489
Mailing Address - Country:US
Mailing Address - Phone:206-229-7227
Mailing Address - Fax:
Practice Address - Street 1:3000 W CECIL AVE
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-1821
Practice Address - Country:US
Practice Address - Phone:661-721-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-11
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program