Basic Information
| Provider Information | |||||||||
| NPI: | 1487031175 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ENYINNA | ||||||||
| FirstName: | CHIDINMA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 533 PARNASSUS AVE # U404 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941432208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262163300 | ||||||||
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| Practice Location | |||||||||
| Address1: | LOMA LINDA UNIVERSITY HEALTH INTERNAL MEDICINE RESIDENC | ||||||||
| Address2: | 11234 ANDERSON STREET | ||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095584074 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2015 | ||||||||
| LastUpdateDate: | 09/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 042.0014923 | VT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.