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General NPI Number Information
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NPI Number | 1396596763
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Entity Type | Organization
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Legal Business Name | HEALTH FIRST PHYSICIAN ASSISTANTS MEDICAL GROUP INC
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Dates
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Enumeration Date | 04/01/2024
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 1416 AVIATION BLVD STE D
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City | REDONDO BEACH
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State | CA
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Zip | 90278-4055
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Country | US
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Telephone | 310-464-7042
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Fax | 888-400-4948
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Provider Business Mailing Address
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Address Line | 11041 SANTA MONICA BLVD # 515
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City | LOS ANGELES
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State | CA
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Zip | 90025-3523
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Country | US
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Telephone | 310-464-7042
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Fax | 888-400-4948
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Authorized Official
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Title or Position | CEO
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Name | HENRY OKONKWO
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Credential | PA
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Telephone | 310-464-7042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 202C00000X
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Taxonomy Name | Independent Medical Examiner Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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