=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578428736
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANGEL O NWOCHIE NURSE PRACTITIONER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2025
-----------------------------------------------------
Last Update Date | 12/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1700 SANTA FE AVE
-----------------------------------------------------
City | LONG BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90813-1200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-521-1050
-----------------------------------------------------
Fax | 805-468-8072
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19422 RADLETT AVE
-----------------------------------------------------
City | CARSON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90746-2686
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-521-1050
-----------------------------------------------------
Fax | 805-468-8072
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ANGEL NWOCHIE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 562-521-1050
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------