Provider Demographics
NPI:1194917369
Name:E AND D NCHEKWUBE, MD, INC
Entity type:Organization
Organization Name:E AND D NCHEKWUBE, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMEKA
Authorized Official - Middle Name:J
Authorized Official - Last Name:NCHEKWUBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-859-3822
Mailing Address - Street 1:PO BOX 636
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95038-0636
Mailing Address - Country:US
Mailing Address - Phone:408-779-5842
Mailing Address - Fax:
Practice Address - Street 1:5390 LITTLE UVAS RD
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-9153
Practice Address - Country:US
Practice Address - Phone:408-779-5842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG39163207T00000X
CAG39162208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ88512ZOtherPTAN
CAZZZ90175ZOtherOLD PTAN AT OTHER OFFICE, WHICH CLOSED