Provider Demographics
NPI:1881056349
Name:OGUELI, VIVIAN CHIMA (MD)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:CHIMA
Last Name:OGUELI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1120 W LA VETA AVE STE 450
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4224
Mailing Address - Country:US
Mailing Address - Phone:714-509-7047
Mailing Address - Fax:714-628-9140
Practice Address - Street 1:1120 W LA VETA AVE STE 450
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4224
Practice Address - Country:US
Practice Address - Phone:714-509-7047
Practice Address - Fax:714-628-9140
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2020-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA152063208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics