Healthcare Provider Details

I. General information

NPI: 1790064913
Provider Name (Legal Business Name): UCHENNA OGBOZOR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2011
Last Update Date: 12/28/2023
Certification Date: 12/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST HARBOR-UCLA/LA BIOMED RB-1 BUILDING
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

2600 GRAHAM AVE
REDONDO BEACH CA
90278-2246
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-1975
  • Fax:
Mailing address:
  • Phone: 310-437-3825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA117143
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number15797
License Number StateND
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA117143
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: