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General NPI Number Information
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NPI Number | 1538717780
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Entity Type | Individual
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Provider Name | DONALD O NWANZE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/30/2019
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Last Update Date | 08/30/2019
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Provider Practice Location Address
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Address Line | MLK OUTPATIENT CENTER (PHARMACY) 1670 EAST 120TH STREET
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City | LOS ANGELES
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State | CA
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Zip | 90059
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Country | US
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Telephone | 424-338-1965
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Fax | 310-223-5997
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Provider Business Mailing Address
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Address Line | PO BOX 721
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City | ARTESIA
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State | CA
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Zip | 90702-0721
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Country | US
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Telephone | 310-704-5160
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Fax |
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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 | 56287
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License Number State | CA
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