Provider Demographics
NPI:1043509243
Name:AJOKU, AARON ANUCHEREBOM (DC,)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:ANUCHEREBOM
Last Name:AJOKU
Suffix:
Gender:M
Credentials:DC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1433
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-1433
Mailing Address - Country:US
Mailing Address - Phone:909-213-4454
Mailing Address - Fax:951-248-0982
Practice Address - Street 1:263 W RIALTO AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-6411
Practice Address - Country:US
Practice Address - Phone:909-820-3130
Practice Address - Fax:951-248-0982
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31897111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor