Provider Demographics
NPI:1871635243
Name:UYANNE, JOHN AZUBIKE (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:AZUBIKE
Last Name:UYANNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 985 ARTESIA CA 90702
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90702
Mailing Address - Country:US
Mailing Address - Phone:562-706-2612
Mailing Address - Fax:562-802-7979
Practice Address - Street 1:8110 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045
Practice Address - Country:US
Practice Address - Phone:562-706-2612
Practice Address - Fax:562-802-7978
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70516207RG0300X
NV9217207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A705160Medicaid
CA00A705160Medicaid