Healthcare Provider Details

I. General information

NPI: 1578428736
Provider Name (Legal Business Name): ANGEL O NWOCHIE NURSE PRACTITIONER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 SANTA FE AVE
LONG BEACH CA
90813-1200
US

IV. Provider business mailing address

19422 RADLETT AVE
CARSON CA
90746-2686
US

V. Phone/Fax

Practice location:
  • Phone: 562-521-1050
  • Fax: 805-468-8072
Mailing address:
  • Phone: 562-521-1050
  • Fax: 805-468-8072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANGEL NWOCHIE
Title or Position: OWNER
Credential:
Phone: 562-521-1050