Provider Demographics
NPI:1427918796
Name:OBIDIKE, CHIOMA AUGUSTINA (RN)
Entity type:Individual
Prefix:
First Name:CHIOMA
Middle Name:AUGUSTINA
Last Name:OBIDIKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 E CASSIDY ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1132
Mailing Address - Country:US
Mailing Address - Phone:424-454-5470
Mailing Address - Fax:
Practice Address - Street 1:558 E CASSIDY ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-1132
Practice Address - Country:US
Practice Address - Phone:424-454-5470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-17
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95406220163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse