Provider Demographics
NPI:1306161625
Name:CHIMA-MELTON, CHIDINMA (MD)
Entity type:Individual
Prefix:DR
First Name:CHIDINMA
Middle Name:
Last Name:CHIMA-MELTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHIDINMA
Other - Middle Name:
Other - Last Name:CHIMA-OKEREKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:955 DEEP VALLEY DR UNIT 3243
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES PENINSULA
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3080
Mailing Address - Country:US
Mailing Address - Phone:310-363-0526
Mailing Address - Fax:310-640-3418
Practice Address - Street 1:1145 W REDONDO BEACH BLVD
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-3511
Practice Address - Country:US
Practice Address - Phone:310-363-0526
Practice Address - Fax:310-640-3418
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125653207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine