Healthcare Provider Details

I. General information

NPI: 1164308482
Provider Name (Legal Business Name): FRANK CHUKWUEMEKA OKAFOR FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 W 58TH ST
LOS ANGELES CA
90037-3632
US

IV. Provider business mailing address

323 GINA DR
CARSON CA
90745-3618
US

V. Phone/Fax

Practice location:
  • Phone: 323-541-1600
  • Fax:
Mailing address:
  • Phone: 310-756-9879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95035727
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: