Healthcare Provider Details

I. General information

NPI: 1508440439
Provider Name (Legal Business Name): OBINNA BENJAMIN AKAH NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 ROSECRANS AVE STE 3230
EL SEGUNDO CA
90245-4749
US

IV. Provider business mailing address

4523 BARNSTONE RIDGE LN
ROSHARON TX
77583-0377
US

V. Phone/Fax

Practice location:
  • Phone: 323-628-8671
  • Fax:
Mailing address:
  • Phone: 940-228-6998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1016767
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95016142
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1016767
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: