Basic Information
| Provider Information | |||||||||
| NPI: | 1689684698 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | UMEH | ||||||||
| FirstName: | IFEANYI | ||||||||
| MiddleName: | CHINEDU | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1615 BUNKER HILL WAY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939066013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317961304 | ||||||||
| FaxNumber: | 8317570291 | ||||||||
| Practice Location | |||||||||
| Address1: | 3155 DE FOREST RD | ||||||||
| Address2: | |||||||||
| City: | MARINA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939332702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8313841445 | ||||||||
| FaxNumber: | 8313841454 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2006 | ||||||||
| LastUpdateDate: | 11/17/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A89280 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | ZZZ15683Z | 01 | CA | MEDICARE GROUP | OTHER |