Healthcare Provider Details

I. General information

NPI: 1467672360
Provider Name (Legal Business Name): MR. NII AHUMA OCANSEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MR. NII AHUMA OCANSEY

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 W WASHINGTON BLVD SUITE 517
LOS ANGELES CA
90015-3552
US

IV. Provider business mailing address

PO BOX 352257
LOS ANGELES CA
90035-0258
US

V. Phone/Fax

Practice location:
  • Phone: 323-935-0663
  • Fax: 323-935-0663
Mailing address:
  • Phone: 323-935-0663
  • Fax: 323-935-0663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: