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General NPI Number Information
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NPI Number | 1508033259
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Entity Type | Individual
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Provider Name | JOHN OKECHUKWU OKONKWO
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Gender | Male
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 1350 E FLORENCE AVE STE BANDC
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City | LOS ANGELES
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State | CA
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Zip | 90001-1963
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Country | US
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Telephone | 323-457-9278
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Fax | 323-457-9265
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Provider Business Mailing Address
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Address Line | 1350 E FLORENCE AVE STE BANDC
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City | LOS ANGELES
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State | CA
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Zip | 90001-1963
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Country | US
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Telephone | 323-457-9278
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Fax | 323-457-9265
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH57029
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 57029
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License Number State | CA
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