Healthcare Provider Details

I. General information

NPI: 1548701535
Provider Name (Legal Business Name): CHIOMA ONYEJEKWE DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2017
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4142 PACIFIC COAST HWY
TORRANCE CA
90505-5714
US

IV. Provider business mailing address

FILE 50670
LOS ANGELES CA
90074-0670
US

V. Phone/Fax

Practice location:
  • Phone: 888-227-3312
  • Fax:
Mailing address:
  • Phone: 888-227-3312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95006287
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: