MEDICARE: IZUCHUKWU DANIEL OKPARA M.D.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	R0292	TX
2	208600000X	Surgery Physician	ME158300	FL
3	208600000X	Surgery Physician	A126340	CA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01836601	OTHER	CA	MEDICARE RAILROAD
2	CA246138	OTHER	CA	MEDICARE NORTH CALIFORNIA
3	CB274828	OTHER	CA	MEDICARE SOUTH CALIFORNIA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1184992851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IZUCHUKWU DANIEL OKPARA M.D.

Provider Business Mailing Address
First Line	:	25044 PEACHLAND AVE STE 110
Second Line	:
City	:	NEWHALL
State	:	CA
Zip	:	91321-5730
Country	:	US
Telephone Number	:	661-383-7136
Fax Number	:	818-356-4380

Provider Business Practice Location Address
First Line	:	28212 KELLY JOHNSON PKWY STE 200
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-5090
Country	:	US
Telephone Number	:	213-228-3538
Fax Number	:	818-356-4380

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2011
Last Update Date	:	05/08/2024

28212 KELLY JOHNSON PKWY STE 215
VALENCIA, CA
91355-5090

Practice Phone: 818-688-6826
Practice Fax: 877-349-4481