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General NPI Number Information
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NPI Number | 1992458608
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Entity Type | Organization
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Legal Business Name | AKPENE GBEGNON MD, INC
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Dates
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Enumeration Date | 02/02/2022
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Last Update Date | 02/02/2022
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Provider Practice Location Address
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Address Line | 6221 WILSHIRE BLVD STE 404
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City | LOS ANGELES
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State | CA
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Zip | 90048-5224
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Country | US
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Telephone | 310-433-8252
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Fax | 310-861-1904
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Provider Business Mailing Address
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Address Line | 11209 NATIONAL BLVD # 158
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City | LOS ANGELES
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State | CA
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Zip | 90064-3902
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Country | US
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Telephone | 310-433-8252
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AKPENE GBEGNON
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Credential | MD
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Telephone | 310-433-8252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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