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General NPI Number Information
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NPI Number | 1235213554
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Entity Type | Individual
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Provider Name | ALOYSIUS IFEANYI UDEZE DC, BSC, IDE, DABDA.
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Gender | Male
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 12613 VENICE BLVD 13523 LEMOLI AVENUE HAWTHORNE, CA 90250
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City | LOS ANGELES
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State | CA
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Zip | 90066-3703
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Country | US
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Telephone | 310-390-9293
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Fax | 323-820-1718
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Provider Business Mailing Address
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Address Line | 11012 CHANERA AVE
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City | INGLEWOOD
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State | CA
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Zip | 90303-2427
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Country | US
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Telephone | 310-390-9293
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Fax | 323-820-1718
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC24645
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License Number State | CA
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