=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841659174
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCIS CHUKWUEMEKA OBI D.O.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/15/2016
-----------------------------------------------------
Last Update Date | 04/14/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1061 E VERNON AVE SUITE F
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-233-9686
-----------------------------------------------------
Fax | 323-233-0595
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8820 SEPULVEDA EASTWAY APT 418
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90045
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-906-8039
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 20A20617
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------