MEDICARE: DIKE OJIGWE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	5706	CA

General Provider Information

NPI Number	:	1740400829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIKE OJIGWE

Provider Business Mailing Address
First Line	:	12534 INGLEWOOD AVE APT 156
Second Line	:
City	:	HAWTHORNE
State	:	CA
Zip	:	90250-4248
Country	:	US
Telephone Number	:	323-752-9723
Fax Number	:

Provider Business Practice Location Address
First Line	:	1704 W MANCHESTER AVE STE 209
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-3057
Country	:	US
Telephone Number	:	323-752-9723
Fax Number	:

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

Provider Enumeration Date	:	04/30/2007
Last Update Date	:	07/08/2007

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Directions to “ DIKE OJIGWE ” Practice Location

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