Healthcare Provider Details

I. General information

NPI: 1285197905
Provider Name (Legal Business Name): CHUKWUEMEKA JOHN OKAFOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: EMEKA JOHN OKAFOR MD

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 WESTWOOD PLAZA, RADIOLOGY SUITE 1638
LOS ANGELES CA
90095-7419
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 310-267-8796
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA182267
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: