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General NPI Number Information
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NPI Number | 1831450519
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Entity Type | Individual
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Provider Name | NNEAMAKA AJALLA PRIEST MD
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Gender | Female
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 01/22/2019
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Provider Practice Location Address
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Address Line | 321 N LARCHMONT BLVD STE 1020
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City | LOS ANGELES
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State | CA
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Zip | 90004-6410
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Country | US
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Telephone | 323-960-8500
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Fax | 323-960-8585
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Provider Business Mailing Address
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Address Line | 321 N LARCHMONT BLVD STE 1020
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City | LOS ANGELES
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State | CA
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Zip | 90004-6410
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Country | US
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Telephone | 323-960-8500
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Fax | 323-960-8585
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 29242
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A151054
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License Number State | CA
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