Healthcare Provider Details

I. General information

NPI: 1023309051
Provider Name (Legal Business Name): CHINWE SONIA KPADUWA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2011
Last Update Date: 10/26/2026
Certification Date: 10/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N LA CIENEGA BLVD STE 150
BEVERLY HILLS CA
90211-3143
US

IV. Provider business mailing address

50 N LA CIENEGA BLVD STE 150
BEVERLY HILLS CA
90211-3143
US

V. Phone/Fax

Practice location:
  • Phone: 424-486-8738
  • Fax: 888-704-4230
Mailing address:
  • Phone: 424-486-8738
  • Fax: 888-704-4230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA143513
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: