Healthcare Provider Details

I. General information

NPI: 1730522384
Provider Name (Legal Business Name): HELEN OLUFUNKE UWADIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2013
Last Update Date: 04/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1632 W 221ST ST
TORRANCE CA
90501-4107
US

IV. Provider business mailing address

1632 W 221ST ST
TORRANCE CA
90501-4107
US

V. Phone/Fax

Practice location:
  • Phone: 310-951-9593
  • Fax:
Mailing address:
  • Phone: 310-951-9593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23010
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: