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NPI 1790338408

NPI 1790338408 : ADANMA FESTA NWACHUKU MD : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1790338408
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    Entity Type          |    Individual 
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    Provider Name        |    ADANMA FESTA NWACHUKU MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/22/2019
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    Last Update Date     |    01/04/2026
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Provider Practice Location Address
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    Address Line         |    1120 W WASHINGTON BLVD 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90015-3316
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    Country              |    US
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    Telephone            |    213-623-2225
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 35380 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89133-5380
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    Country              |    US
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    Telephone            |    702-579-3203
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    A181651
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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