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General NPI Number Information
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NPI Number | 1194611285
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Entity Type | Organization
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Legal Business Name | PRAISE CLINIC A NURSING PC
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 24022 VISTA MONTANA STE B
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City | TORRANCE
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State | CA
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Zip | 90505-6479
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Country | US
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Telephone | 310-346-6847
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Fax |
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Provider Business Mailing Address
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Address Line | 30203 VIA RIVERA
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-4457
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO & PRESIDENT
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Name | UGOCHI HOMMEY
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Credential |
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Telephone | 310-346-6847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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