Healthcare Provider Details

I. General information

NPI: 1396664231
Provider Name (Legal Business Name): UGOCHINYERE UMEKWE-ODUDU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: UGO UMEKWE-ODUDU

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 E 120TH ST
LOS ANGELES CA
90059-3051
US

IV. Provider business mailing address

9207 OLIVE ST
BELLFLOWER CA
90706-4451
US

V. Phone/Fax

Practice location:
  • Phone: 323-568-3347
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberP000044356
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: