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General NPI Number Information
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NPI Number | 1023517315
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Entity Type | Organization
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Legal Business Name | HABONA SERVICES
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 02/02/2018
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Provider Practice Location Address
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Address Line | 4405 S MAIN ST
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City | LOS ANGELES
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State | CA
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Zip | 90037-2731
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Country | US
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Telephone | 323-231-0659
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2501
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City | GARDENA
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State | CA
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Zip | 90247-0501
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Country | US
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Telephone | 310-972-8843
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. NKONYE EZEOBAH
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Credential | FNP-C, RNC-MNN, EDD
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Telephone | 310-972-8843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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