Healthcare Provider Details

I. General information

NPI: 1942870381
Provider Name (Legal Business Name): JOSEPH OKORIE FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 06/28/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16710 ORANGE AVE UNIT T88
PARAMOUNT CA
90723-6902
US

IV. Provider business mailing address

16710 ORANGE AVE UNIT T88
PARAMOUNT CA
90723-6902
US

V. Phone/Fax

Practice location:
  • Phone: 562-889-1924
  • Fax:
Mailing address:
  • Phone: 562-889-1924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95017487
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: