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General NPI Number Information
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NPI Number | 1801806674
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Entity Type | Individual
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Provider Name | IKECHUKWU ARENE M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 5400 BALBOA BLVD STE 120
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City | ENCINO
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State | CA
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Zip | 91316-5200
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Country | US
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Telephone | 818-290-3289
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Fax |
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Provider Business Mailing Address
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Address Line | 11325 PARK SQUARE DR APT K202
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City | BAKERSFIELD
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State | CA
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Zip | 93311-8869
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Country | US
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Telephone | 661-873-5887
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | C51962
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C51962
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License Number State | CA
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