Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A94067 | CA |
Y | 208600000X | Surgeon | A94067 | CA |
N | 2086X0206X | Surgical Oncologist | A94067 | CA |
NPI | 1023283124 |
---|---|
Provider Name | Evelyn Lillian Kachikwu |
First Address | Placentia, CA 92870-3840 |
Second Address | Placentia, CA 92870-3840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2008 |
Last Update Date | 27/10/2015 |