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General NPI Number Information
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NPI Number | 1790824886
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Entity Type | Organization
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Legal Business Name | JANET MEDICAL CLINIC, INC
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1776 W ADAMS BLVD SUITE B
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City | LOS ANGELES
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State | CA
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Zip | 90018-2704
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Country | US
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Telephone | 323-732-4224
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Fax | 323-732-4234
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Provider Business Mailing Address
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Address Line | 1776 W ADAMS BLVD SUITE B
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City | LOS ANGELES
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State | CA
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Zip | 90018-2704
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Country | US
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Telephone | 323-732-4224
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Fax | 323-732-4234
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. CHINYERE ALICE NYENKE
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Credential | M.D.
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Telephone | 323-732-4224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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