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General NPI Number Information
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NPI Number | 1841924818
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Entity Type | Organization
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Legal Business Name | SHINNEL MEDICAL GROUP INC
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Dates
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Enumeration Date | 07/14/2022
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Last Update Date | 12/28/2022
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Provider Practice Location Address
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Address Line | 5155 W ROSECRANS AVE STE 220
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City | HAWTHORNE
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State | CA
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Zip | 90250-6663
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Country | US
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Telephone | 213-564-4040
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Fax |
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Provider Business Mailing Address
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Address Line | 7824 BANGLE RD
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City | DOWNEY
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State | CA
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Zip | 90240-2620
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Country | US
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Telephone | 213-564-4040
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ADAOBI OZOH
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Credential |
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Telephone | 213-564-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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