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General NPI Number Information
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NPI Number | 1447249818
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Entity Type | Organization
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Legal Business Name | STANLEY N. IGBOAKAEZE
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 15342 HAWTHORNE BLVD SUITE 206
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City | LAWNDALE
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State | CA
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Zip | 90260-2192
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Country | US
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Telephone | 310-349-8346
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Fax | 310-988-2194
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Provider Business Mailing Address
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Address Line | 15342 HAWTHORNE BLVD SUITE 206
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City | LAWNDALE
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State | CA
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Zip | 90260-2192
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Country | US
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Telephone | 310-349-8346
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Fax | 310-988-2194
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Authorized Official
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Title or Position | OWNER
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Name | MR. STANLEY N IGBOAKAEZE
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Credential |
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Telephone | 310-349-8346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 103577
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License Number State | CA
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