Provider Demographics
NPI:1770872434
Name:ECHEGI, EUGENE CHUKWUDI (B PHARM)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:CHUKWUDI
Last Name:ECHEGI
Suffix:
Gender:M
Credentials:B PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1239 E A ST
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361-2714
Mailing Address - Country:US
Mailing Address - Phone:209-408-5465
Mailing Address - Fax:
Practice Address - Street 1:1449 E F ST
Practice Address - Street 2:FOOTHILL SHOPPING COMPLEX, SUITE 102
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-9265
Practice Address - Country:US
Practice Address - Phone:209-847-4279
Practice Address - Fax:209-848-3210
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65175183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist