MEDICARE: MRS. EBERE HENRIETTA ANAKWENZE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA14471	CA

General Provider Information

NPI Number	:	1164598280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EBERE HENRIETTA ANAKWENZE PA

Provider Business Mailing Address
First Line	:	1045 ATLANTIC AVENUE
Second Line	:	SUITE 715
City	:	LONG BEACH
State	:	CA
Zip	:	90813-3412
Country	:	US
Telephone Number	:	562-983-5496
Fax Number	:	562-432-1864

Provider Business Practice Location Address
First Line	:	555 W COMPTON BLVD
Second Line	:	SUITE 205
City	:	COMPTON
State	:	CA
Zip	:	90220-3085
Country	:	US
Telephone Number	:	310-223-0684
Fax Number	:	310-223-0687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	08/26/2025

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