Healthcare Provider Details

I. General information

NPI: 1083973036
Provider Name (Legal Business Name): NNEKA ORJIAKOR KAMDEM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NNEKA TELMA ORJIAKOR

II. Dates (important events)

Enumeration Date: 05/11/2012
Last Update Date: 11/04/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 S MAIN ST
LOS ANGELES CA
90003-1215
US

IV. Provider business mailing address

21504 S ROSITA DR
CARSON CA
90745-1655
US

V. Phone/Fax

Practice location:
  • Phone: 310-513-8060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA123760
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA123760
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number123760
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: