Provider Demographics
NPI:1548670854
Name:OCHONMA, RICHARD UCHECHUKWU (BPHARM)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:UCHECHUKWU
Last Name:OCHONMA
Suffix:
Gender:M
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:678 N WILSON WAY STE 15
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95205-4200
Mailing Address - Country:US
Mailing Address - Phone:209-467-7861
Mailing Address - Fax:
Practice Address - Street 1:678 N WILSON WAY STE 15
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95205-4200
Practice Address - Country:US
Practice Address - Phone:209-467-7861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70638183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist